Treatment of Non‑Infectious Corneal Injury - Review of Diagnostic Agents, Therapeutic Medications, and Future Targets

Aug 24, 2026

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Corneal injuries arise from traumatic, chemical, inflammatory, metabolic, autoimmune, or iatrogenic causes, and ocular infection can coincide though antimicrobials are excluded from this review. Diagnostic and treatment strategies emphasize clinical examination supported by staining agents such as fluorescein, lissamine green, and rose bengal, along with analgesic cycloplegics including atropine, cyclopentolate, scopolamine, and homatropine. Steroidal anti-inflammatory agents are discussed with attention to risks like elevated intraocular pressure and cataract, contrasted with non-steroidal drugs for inflammation control. The review also covers amniotic membrane therapies, blood-based treatments, protective surface methods, glue approaches, and emerging options such as cenegermin for neurotrophic disease.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages23

Reading Time58 min

AccessFree to download

Key Points

Diagnostic and Analgesic Agents

Anti-inflammatory Therapies

Ocular Surface Disease Management

Amniotic Membrane and Blood-based Therapies

Protective, Barrier, and Glue Methods

Emerging Agents and Future Targets

Introduction

Drugs (2022) 82:145–167 [https://doi.org/10.1007/s40265-021-01660-5](https://doi.org/10.1007/s40265-021-01660-5) Treatment of Non‑Infectious Corneal Injury: Review of Diagnostic Agents, Therapeutic Medications, and Future Targets Deanna H. Dang1 · Kamran M. Riaz1 · Dimitrios Karamichos2,3,4 Accepted: 2 December 2021 / Published online: 13 January 2022 © The Author(s) 2022 Abstract Corneal injuries can occur secondary to traumatic, chemical, inflammatory, metabolic, autoimmune, and iatrogenic causes. Ocular infection may frequently occur concurrent to corneal injury; however, antimicrobial agents are excluded from this present review. While practitioners may primarily rely on clinical examination techniques to assess these injuries, several pharmacological agents, such as fluorescein, lissamine green, and rose bengal, can be used to formulate a diagnosis and develop effective treatment strategies. Practitioners may choose from several analgesic medications to help with patient comfort without risking further injury or delaying ocular healing. Atropine, cyclopentolate, scopolamine, and homatropine are among the most frequently used medications for this purpose. Additional topical analgesic agents may be used judiciously to augment patient comfort to facilitate diagnosis. Steroidal anti-inflammatory agents are frequently used as part of the therapeutic regimen. A variety of commonly used agents, including prednisolone acetate, loteprednol, difluprednate, dexamethasone, fluorometholone, and methylprednisolone are discussed. While these medications are effective for controlling ocular inflammation, side effects, such as elevated intraocular pressure and cataract formation, must be monitored by clinicians. Non-steroidal medications, such as ketorolac, bromfenac, nepafenac, and diclofenac, are additionally used for their efficacy in controlling ocular inflammation without incurring side effects seen with steroids. However, these agents have their own respective side effects, warranting close monitoring by clinicians. Additionally, ophthalmologists routinely employ several agents in an off-label manner for supplementary control of inflammation and treatment of corneal injuries. Patients with corneal injuries not infrequently have significant ocular surface disease, either as a concurrent pathology or as an exacerbation of previously existing disease. Several agents used in the management of ocular surface disease have also been found to be useful as part of the therapeutic armamentarium for treatment of corneal injuries. For example, several antibiotics, such as doxycycline and macrolides, have been used for their anti-inflammatory effects on specific cytokines that are upregulated during acute injuries. There has been a recent wave of interest in amniotic membrane therapies (AMTs), including topical, cryopreserved and dehydrated variants. AMT is particularly effective in ocular injuries with violation of corneal surface integrity due to its ability to promote reepithelialization of the corneal epithelium. Blood-based therapies, including autologous serum tears, plasma-enriched growth factor eyedrops and autologous blood drops, have additionally been explored in small case series for effectiveness in challenging and recalcitrant cases. Protection of the ocular surface is also a vital component in the treatment of corneal injuries. Temporary protective methods, such as bandage contact lenses and mechanical closure of the eyelids (tarsorrhaphy) can be particularly helpful in selective cases. Glue therapies, including biologic and non-biologic variants, can also be used in cases of severe injury and risk of corneal perforation. Finally, there are a variety of recently introduced and in-development agents that may be used as adjuvant therapies in challenging patient populations. Neurotrophic corneal disease may occur as a result of severe or chronic injury. In such cases, recombinant human nerve growth factor (cenegermin), top

FAQs

Which causes of corneal injuries does the review cover?

The review covers traumatic, chemical, inflammatory, metabolic, autoimmune, and iatrogenic causes. It also notes that ocular infection may occur concurrently, while antimicrobial agents are excluded from the review.

How are diagnostic agents and analgesics used in non-infectious corneal injury?

Fluorescein, lissamine green, and rose bengal are used for diagnosis and to support effective treatment planning. For comfort without delaying healing, cycloplegic analgesic medications such as atropine, cyclopentolate, scopolamine, and homatropine are highlighted, with additional topical analgesics used selectively.

What future or emerging therapies are discussed beyond standard anti-inflammatory treatment?

The review describes amniotic membrane therapies (including topical, cryopreserved, and dehydrated variants) and blood-based treatments such as autologous serum tears and plasma-enriched growth factor eyedrops. It also discusses protective measures like bandage contact lenses and tarsorrhaphy, glue therapies to reduce perforation risk, and novel agents including cenegermin and topical insulin for neurotrophic corneal disease.

Aug 24, 2026

Upload by Asher