Dawaa Reference

chronic

Simple corneal abrasion

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources7 sources

Egyptian National Drug Formulary - Antimicrobial 2023 · AAO Corneal Abrasion Guidelines · Exocin 3 mg/ml Eye Drops SmPC section 4.2 (eMC product 1353) · No labelled dose - a lubricant appliance, not a licensed medicine; instilled as often as comfort needs · Tobramycin 0.3% eye drops SmPC (https://www.medicines.org.uk/emc/product/3120/smpc) · Corneal Abrasion - StatPearls - NCBI Bookshelf - disease-level clinical article (corneal-abrasion-full.txt) · Domingo E, Moshirfar M, Zeppieri M, et al. Corneal Abrasion. [Updated 2024 Jan 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Bookshelf ID NBK532960.

Verified against7 documents
  • Egyptian National Drug Formulary - Antimicrobial 2023
  • Exocin 3 mg/ml Eye Drops SmPC section 4.2 (eMC product 1353)
  • No labelled dose - a lubricant appliance, not a licensed medicine; instilled as often as comfort needs
  • Tobramycin 0.3% eye drops SmPC (https://www.medicines.org.uk/emc/product/3120/smpc)
  • Corneal Abrasion - StatPearls (NBK532960), Treatment / Management
  • Corneal Abrasion - StatPearls - NCBI Bookshelf - disease-level clinical article (corneal-abrasion-full.txt)
  • Domingo E, Moshirfar M, Zeppieri M, et al. Corneal Abrasion. [Updated 2024 Jan 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Bookshelf ID NBK532960.

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (6)

  • Trouble getting the eye open, dislike of light and a gritty feeling with pain all point to injury of the cornea [photophobia]
  • Redness, sensitivity to light, streaming tears and blurred vision go with it [blurred vision · photophobia · redness]
  • Marked screwing up of the eye is part of the picture
  • Small fragments from woodwork or metalwork can lodge under the lid and graze the cornea
  • Usual causes are a poke from a finger or nail, make-up, branches, grit, contact lenses, splashed chemicals, hard rubbing, radiation burns and ingrowing lashes
  • Injuries to the eye frequently go unmentioned unless you ask

Signs — what you find (8)

  • The dye pools in the break and glows green under a cobalt blue lamp
  • Look for a red bulbar conjunctiva, slight corneal swelling, engorged ciliary vessels and a small pupil [small pupil]
  • A pupil that is not properly round raises the possibility of a ruptured globe
  • A hazy cornea means oedema from hard rubbing or damage to epithelium and stroma [corneal changes · oedema]
  • An opacity or an infiltrate in the cornea suggests an ulcer or infection instead
  • Blood or pus settled in the front chamber calls for immediate referral to an ophthalmologist [pus]
  • A graze over the middle of the cornea drops the acuity, and a marked drop warrants specialist referral
  • Note any abnormality of eye movement

Tests (8)

  • Staining with fluorescein is the single most useful bedside test
  • Put anaesthetic in the eye or on the strip, touch it to the conjunctiva; the dye runs off intact cornea and lodges in any break
  • If pain prevents the patient sitting at the slit lamp, begin with a torch
  • Topical anaesthetic makes the examination possible
  • Injury leaves a line-shaped or map-shaped stain
  • In a lens wearer, scattered pinpoint marks run together into a rounded defect in the middle
  • A branching pattern of uptake means herpes keratitis and needs treating at once
  • Upright scratch lines mean something is sitting under the lid, so turn the lids back and look

If not this — what else fits (8)

  • Keratoconjunctivitis
  • Dry eye syndrome
  • Angle-closure glaucoma of sudden onset
  • Uveitis, or keratitis from bacteria, fungus or herpes
  • Ulcer of the cornea
  • Recurrent erosion syndrome
  • Neurotrophic exposure keratopathy, or a complication of previous surgery
  • Ingrowing lashes, and keratitis from ultraviolet light or chemicals

SourceStatPearls "Corneal Abrasion" - disease-level clinical article

Presentation findings are traced to the source above.

Rx: Prophylaxis | Contact lens wearer - Pseudomonas cover | Prophylaxis - not obtainable in Egypt | Main treatment

PROPHYLAXIS

1

TOBRAMYCIN

Prophylaxis

1st line

Formeye

Adult dose and duration

Instill 1-2 drops into affected eye(s) every 4 hours

Paediatric dose

(Children >2 months: Instill 1-2 drops into affected eye(s) every 4 hours)

Dose by age
3 months and over:1 to 2 drops into affected eye every 4 hours.
Dose source

Tobramycin 0.3% eye drops SmPC (https://www.medicines.org.uk/emc/product/3120/smpc)

Why

Prophylactic topical antibiotic to prevent bacterial keratitis while epithelium heals

Cautions
  • CONTACT LENS WEARERS REQUIRE PSEUDOMONAS COVER (e.g. ofloxacin or levofloxacin) and MUST NOT wear lenses until 24 hours after full epithelial closure.
  • NEVER prescribe topical anesthetic drops (tetracaine/benoxinate) for outpatient home use (causes rapid corneal melting and permanent blindness).
  • Do NOT patch the eye if contact-lens-related or organic/plant material injury (high infection risk).
  • RED FLAG - Topical corticosteroid drops must never be used on a corneal abrasion - they delay healing and increase the risk of infection.
  • An irregularly shaped pupil after eye trauma suggests globe rupture and needs immediate ophthalmology involvement.
  • RED FLAG - Aminoglycoside eye drops should be avoided in patients who do not wear contact lenses.
  • Evert both eyelids before concluding the examination - a retained subtarsal foreign body typically produces vertical linear corneal scratches.
  • Branching, dendritic fluorescein staining is herpes keratitis rather than a simple abrasion and needs immediate treatment.
  • RED FLAG - Do not patch an uncomplicated minor traumatic or foreign-body corneal abrasion.
  • Inspect the anterior chamber for blood in it (hyphema) at the first examination.
  • Any significant reduction in visual acuity requires referral to an ophthalmologist.
  • RED FLAG - Purulent discharge, or a drop in vision of more than one to two Snellen lines, is an indication for urgent ophthalmology referral.
  • RED FLAG - A child who is still unwilling to open the injured eye 24 hours later needs urgent ophthalmology referral.
Egyptian brands
Egyptian brandManufacturerIndicative price
SWIXTOBRAM 0.3% EYE DROPS 5 MLCHEMIPHARM6.50 EGP
T GRAND 0.3% EYE DROPS 5 MLDELTA GRAND PHARMA7.00 EGP
TOBRAL 0.3% EYE DROPS 5 MLKAHIRA7.00 EGP
TOBRACTIVA 0.3% EYE DROPS 5 MLEPCI18.00 EGP
AVAZIR 0.3% EYE DROPS 10 MLORCHIDIA PHARMACEUTICAL INDUSTRIES > ORCHIDIA28.00 EGP
TOBREX 0.3% EYE DROPS 5 MLNOVARTIS > NOVARTIS SCIENTIFIC OFFICE32.50 EGP
TOBRIN 0.3% EYE.OINT. 5 GMEIPICO23.00 EGP
AVAZIR 0.3% EYE OINT. 5 GMORCHIDIA PHARMACEUTICAL INDUSTRIES > ORCHIDIA26.00 EGP

CONTACT LENS WEARER - PSEUDOMONAS COVER

2

OFLOXACIN

Contact lens wearer - Pseudomonas cover

1st line

Formeye

Adult dose and duration

1-2 drops into the affected eye every 2-4 hours for the first 2 days, then 4 times daily. Never longer than 10 days. x 5-7 days, maximum 10

Paediatric dose
Dose by age
For all ages (1 year and older):one to two drops in the affected eye(s) every two to four hours for the first two days and then four times daily. Safety and effectiveness in infants below the age of one year have not been established.
Dose source

Exocin 3 mg/ml Eye Drops SmPC section 4.2 (eMC product 1353)

Why

For a contact lens wearer, where the organism to fear is Pseudomonas. Drops cost 6 EGP, so there is no reason to compromise on cover.

Cautions
  • The label warns of corneal perforation when a fluoroquinolone drop is used on an eye with an epithelial defect - which is what an abrasion is. Review the eye, and refer if it is not healing.
  • A contact lens wearer with an abrasion does not go back into lenses until the eye is healed and reviewed.
  • Refer same day for any white infiltrate, hypopyon, or vision that is getting worse - that is keratitis, not an abrasion.
  • Recommended that EXOCIN not be used in pregnant women.
Egyptian brands
Egyptian brandManufacturerIndicative price
QUIFLURO 0.3% EYE DROPS 5 MLPHAROPHARMA6.00 EGP
OFLOXIN 0.3% EYE DROPS 5 MLKAHIRA7.00 EGP
OFLOXACIN 0.3% EYE DROPS 10 MLSIGMA TEC7.50 EGP
OFLICIN 0.3% EYE DROPS 5 MLMEMPHIS8.00 EGP
OFLOSWIX 0.3% EYE DROPS 5 MLCHEMIPHARM12.00 EGP
OCUFLOX 0.3% EYE DROPS 5 MLALEXANDRIA19.50 EGP
OPTIFLOX 0.3% EYE DROPS 5 MLJAMJOOM PHARMACEUTICALS-K.S.A > JAMJOOM PHARMA19.50 EGP
OFLOX 0.3% EYE DROPS 5 MLALLERGAN > SOFICOPHARM20.40 EGP

PROPHYLAXIS - NOT OBTAINABLE IN EGYPT

3

ERYTHROMYCIN

Prophylaxis - not obtainable in Egypt

1st line

Formeye

Adult dose and duration

Erythromycin ointment, 4 times a day across the 5 days, for a patient who does not wear contact lenses. x 5 days

Paediatric dose

30-50 mg/kg/day [child max 2000 mg]

(General dosing, susceptible infection: Infants, Children, and Adolescents: Oral: Base, ethylsuccinate, stearate: 30 to 50 mg/kg/day divided every 6 to 8 hours usually; for severe infection may double dose; maximum daily dose: Mild to moderate infection: 2,000 mg/day; severe infection: 4,000 mg/day.)

Dose by weight
3kg90-150 mg/day
4kg120-200 mg/day
5kg150-250 mg/day
6kg180-300 mg/day
7kg210-350 mg/day
8kg240-400 mg/day
9kg270-450 mg/day
10kg300-500 mg/day
11kg330-550 mg/day
12kg360-600 mg/day
13kg390-650 mg/day
14kg420-700 mg/day
15kg450-750 mg/day
16kg480-800 mg/day
17kg510-850 mg/day
18kg540-900 mg/day
19kg570-950 mg/day
20kg600-1000 mg/day
21kg630-1050 mg/day
22kg660-1100 mg/day
23kg690-1150 mg/day
24kg720-1200 mg/day
25kg750-1250 mg/day
26kg780-1300 mg/day
27kg810-1350 mg/day
28kg840-1400 mg/day
29kg870-1450 mg/day
30kg900-1500 mg/day
31kg930-1550 mg/day
32kg960-1600 mg/day
33kg990-1650 mg/day
34kg1020-1700 mg/day
35kg1050-1750 mg/day
36kg1080-1800 mg/day
37kg1110-1850 mg/day
38kg1140-1900 mg/day
39kg1170-1950 mg/day
40kg1200-2000 mg/day
41kg1230-2000 mg/day (upper capped)
42kg1260-2000 mg/day (upper capped)
43kg1290-2000 mg/day (upper capped)
44kg1320-2000 mg/day (upper capped)
45kg1350-2000 mg/day (upper capped)
46kg1380-2000 mg/day (upper capped)
47kg1410-2000 mg/day (upper capped)
48kg1440-2000 mg/day (upper capped)
49kg1470-2000 mg/day (upper capped)
50kg1500-2000 mg/day (upper capped)
Dose source

Corneal Abrasion - StatPearls - NCBI Bookshelf - disease-level clinical article (corneal-abrasion-full.txt) for the topical ointment regimen; the systemic paediatric figures are from Egyptian National Drug Formulary - Antimicrobial 2023 (erythromycin monograph), Dosing: Pediatric, general dosing: "Oral: Base, ethylsuccinate, stearate: 30 to 50 mg/kg/day divided every 6 to 8 hours usually; for severe infection may double dose; maximum daily dose: Mild to moderate infection: 2,000 mg/day; severe infection: 4,000 mg/day".

Why

Topical antibiotic ointment providing antibiotic cover and ocular lubrication for simple corneal abrasion in non-contact lens wearers.

Cautions
  • Erythromycin is not obtainable in Egypt in this form. Every erythromycin eye product is absent from the national product list entirely, all 16 oral products are marked withdrawn, and the only three live topical products are acne preparations. Prescribe tobramycin or ofloxacin eye drops instead - both are stocked and cover the same job, tobramycin for a patient who does not wear lenses, ofloxacin for one who does.
  • For non-contact lens wearers only; contact lens wearers require anti-pseudomonal coverage (e.g. fluoroquinolone or aminoglycoside).
  • Re-evaluate if symptoms persist beyond 3 days.
Egyptian brands
Egyptian brandManufacturerIndicative price
AKNEMYCIN 2% OINT. 15 GM? different route - not eyediscontinuedMUP > HERMAL-GERMANY5.00 EGP
ACNI-CARE 2% TOP. GEL. 20 GM? different route - not eyediscontinuedSIGMA6.50 EGP
ERYTHROCID 200 MG/5ML SUSP. 60ML? different route - not eyediscontinuedCID5.60 EGP
ERYTHROMYCIN PHARCO 200MG/5ML SUSP. 60ML? different route - not eyediscontinuedPHARCO7.50 EGP
AKNEMYCIN 2% SOLUTION 25 ML? different route - not eyediscontinuedMUP > HERMAL-GERMANY9.00 EGP
ETHYRONATE 200MG/5ML SUSP. 100 ML? different route - not eyediscontinuedUNIPHARMA CO. > UNIPHARMA9.50 EGP
ETHYRONATE 400MG/5ML SUSP. 100 ML? different route - not eyediscontinuedUNIPHARMA CO. > UNIPHARMA11.75 EGP
ACNI-CARE 2% LOTION 25 ML? different route - not eyediscontinuedSIGMA20.00 EGP

MAIN TREATMENT - give alongside

4

SODIUM HYALURONATE

add-on - not a substitute

Formeye

Adult dose and duration

Instill preservative-free lubricating drops 1-2 drops every 2-4 hours as needed for comfort x 3-5 days

Paediatric dose

Preservative-free lubricating drops as needed

Dose source

No labelled dose - a lubricant appliance, not a licensed medicine; instilled as often as comfort needs

Why

Promotes epithelial re-surfacing and reduces eyelid friction

Cautions
  • Re-evaluate within 24-48 hours if pain worsens, photophobia increases, or vision degrades.
  • Sodium hyaluronate drops are sold as an appliance rather than a licensed medicine, so no regulator has set a dose for them. Use them as often as the eye needs and judge by comfort.
Egyptian brands
Egyptian brandManufacturerIndicative price
LUBRIVISC 0.1% EYE DROPS 10 MLRAMEDA > HIKMA PHARMA32.00 EGP
HYALUGRAND 0.2% EYE DROPS 10 MLDELTA GRAND PHARMA41.00 EGP
HYALOPTIC 0.2% EYE DROPS 10 MLPHARCO48.00 EGP
HYFRESH 0.2% EYE DROPS 10 MLJAMJOOM PHARMACEUTICALS75.00 EGP
XILOIAL MONO EYE DROPS 20 RE-CLOSABLE VIALS * 0.5 MLFARMIGEA > HABIB SCIENTIFIC OFFICE265.00 EGP
VISMED MULTI 0.18% EYE DROPS 10 MLTRB CHEMEDICA SA > RHEUMA335.00 EGP
VISMED 0.3% EYE GEL 20 X 0.45 ML SDUTRB CHEMEDICA SA > RHEUMA390.00 EGP
VISMED MULTI 0.3% EYE GEL 10 MLTRB CHEMEDICA SA > RHEUMA390.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.