In corneal foreign body treatment, which step is recommended specifically if there is a large epithelial defect?

• A. Place a bandage contact lens
• B. Remove rust ring with Alger brush
• C. Instill Proparacaine and remove with instrument
• D. Moxifloxacin 0.5% qid x1 week

Answer: (A)

When a corneal foreign body leaves a large epithelial defect, the priority is to protect the delicate surface and promote re-epithelialization. A bandage contact lens provides a protective, lubricated covering over the cornea, reduces friction from blinking, and creates a moist environment that supports faster healing and less pain. This direct support for the healing surface is why it’s the recommended step in this situation.

The other options don’t address the healing surface as effectively: removing rust rings can cause additional corneal trauma, especially on a compromised surface; instilling topical anesthetic to facilitate removal can delay healing and carries toxicity risks with repeated use; and while antibiotics help prevent infection, they don’t provide the protective, healing-promoting effect that a bandage lens offers.