Corneal Abrasion

A guide to corneal abrasions, which may be mild or severe, and how they are treated, prevented and diagnosed.

A corneal abrasion is a scrape or scratch on the cornea. The cornea is the clear, protective covering at the front of the eye, and it is the first part of the eye to refract light. The cornea contains several nerve endings just beneath its surface. When these nerve endings are disrupted or damaged, severe pain can result.

Symptoms of a Corneal Abrasion

Symptoms vary from person to person, depending on the severity and location of the abrasion. Corneal abrasion symptoms include:

• Pain, typically severe
• Photophobia (sensitivity to light)
• Feeling like a foreign object is in your eye
• Watery eye
• Impaired, blurry, or hazy vision
• Redness in the sclera (the white part of eye)
• Crusty or fluid-like discharge from affected eye
• Excessive squinting
• Swollen eyelids
• Enlarged pupils

What Causes Corneal Abrasions?

Typically, corneal abrasions are the result of an injury to the cornea. Common causes include:

• Something in the air flies into the eye, such as dust particles
• Scratching your eye while rubbing it with your finger
• Wearing hard contact lenses for too long
• Removing contact lenses
• Dry eyes can cause the cornea to dry and become brittle and weak

Diagnosing a Corneal Abrasion

If you are experiencing symptoms of a corneal abrasion or have injured your eye, you should seek medical attention for proper diagnosis and treatment. During your eye exam, your eye doctor will ask you questions about your daily activities, possible causes of the abrasion, symptoms you are experiencing, and whether you have any eye diseases or disorders such as glaucoma. Numbing eye drops are used to temporarily relieve pain and to allow your eye to remain open during the actual examination. Yellow-colored eye drops are used in conjunction with a blue light. The drops contain a dye called fluorescein that enhances the corneal abrasion and makes for an easier diagnosis.

Corneal Abrasion Treatment

Most minor abrasions do not need treatment and heal on their own within a few days, but the nature of your treatment will depend on the cause of the abrasion. For example, if you were hiking and were poked in the eye by a tree branch, your eye doctor might prescribe an antibiotic to prevent an infection or corneal ulcer. But if your abrasion is the result of a piece of dust flying into your eye, you may only need to wash your eye out with water. Over-the-counter products such as artificial tears or lubricants can relieve discomfort temporarily, while products such as Tylenol can relieve pain. Wearing sunglasses may also reduce pain for some people.

Most eye doctors suggest resting your eyes as much as possible by keeping them closed. For most people, activities such as reading and driving are not recommended during the healing process. Eye drops containing steroids may be used to reduce inflammation and to prevent corneal scarring. Your eye doctor may want to use eye drops that control muscle spasms in your eye to relieve pain and photophobia.

In some cases, an eye patch may be required, although recent evidence suggests that eye patches do nothing to treat corneal abrasions and may in fact have a negative impact on the healing process. Ophthalmologists usually have specific reasons for requiring the use of an eye patch. In most cases eye patches have no significant effect on the outcome of treatment. Talk with your eye doctor for more information about patches.

Depending on the nature of the injury, a tetanus vaccination may be recommended, especially if you are not up to date in your immunization records.

Corneal Abrasion Risk Factors

People of all ages are at risk for corneal abrasions. A direct injury caused by an object such as a pencil, staple, or fingernail can cause an abrasion on the cornea. In some cases a person’s job may increase their risk. For example, farmers, woodworkers, and construction workers all work in environments that contain flying particles such as dust and sand. Additional factors that can increase your risk of developing a corneal abrasion include:

• Wearing contact lenses
• Improper contact lens hygiene, e.g., not washing your hands before handling your contacts, or wearing them overnight
• Recent eye infection
• Severe allergies
• Severe dry eyes
• Failure of athletes to wear protective eye-wear during athletic activities
• Small children playing with pointed objects
• Excessive rubbing of your eyes

Complications of Corneal Abrasions

Complications from corneal abrasions can occur if treatment is not sought. Scratches to your cornea can lead to corneal ulcers, or open sores on your cornea. Infection can spread to other parts of your eye, and can result in temporary or permanent changes in your vision, including vision loss. If the abrasion is severe, scarring could be a possibility. In some cases, a corneal transplant is needed. A corneal transplant involves removing a damaged cornea and replacing it with a new one. Typically this procedure requires a two-day hospital stay, after which recovery takes approximately three to four weeks.

Preventing a Corneal Abrasion

Here are some tips to prevent corneal abrasions:

• Wear protective eyewear in environments where there are flying particles.
• Wear protective eyewear when participating in athletic activities.
• Wear protective eyewear in the sun or in any other bright environment.
• Limit use of pointed objects.
• Handle contact lenses properly, and wash your hands before handling lenses.
• Do not wait to seek medical attention if an eye injury has occurred.

When to See Your Eye Doctor

Contact your eye doctor if you suspect a corneal abrasion, or if:

• You have eye pain but are unaware of an eye injury
• You injure your eye
• Pain lasts longer than a few hours
• You experience a sudden decrease or loss of vision
• Your eyes are red for unknown reason
• You feel like you have a foreign object in your eye
• You have been exposed to chemicals or radiation
• Pain continues after self-treatment
• Pain and/or symptoms continue after receiving medical treatment

Questions to Ask Your Doctor

• How severe is the abrasion to my cornea?
• How long will the symptoms last?
• What are my treatment options?
• Will there be any long-term complications from this problem?
• How long should I wait to contact you if symptoms persist after treatment?