A corneal abrasion refers to a scratch, scrape or cut on the epithelium (the outermost surface of the cornea). It can lead to loss of the epithelium. The cornea is the transparent, dome-shaped window of the iris and pupil of the eye. It helps to focus light that enters the eye. Thus, a corneal abrasion can affect vision.
Most corneal abrasions have no permanent effect on vision. However, a deeper abrasion, especially in the center of the cornea, may leave a slight scar. The scar can sometimes cause a blurred vision. It can also cause sensitivity to glare. A foreign body in the eye can cause a vertical corneal abrasion. This abrasion may grow worse with blinking.
Also Known As
- Corneal erosion
- Scratched eye
Causes and Risk Factors
A corneal abrasion is caused by:
- Being poked in the eye especially by babies. Tree limbs and bushes can poke the eye too.
- Vigorous rubbing
- Foreign bodies like metal, wood, plastic and others
- Contact lenses that are not correctly fitted or maintained
- Sports injuries
- Surgery under general anesthesia
People with corneal diseases and dystrophies can develop corneal abrasion. This can happen even without trauma to the eye. Dystrophy is a condition where one or more parts of the cornea lose their usual clarity. The loss of clarity is due to a buildup of material.
A corneal abrasion can also develop in people with trachoma. It can also arise due to a bacterial infection.
Signs & Symptoms
- A lot of pain in the eye especially when closing and opening the eye
- Blurred vision or loss of vision
- Red eyes
- A headache
- The feeling of something is in the eye
- Sensitivity to light
The eye professional will conduct a thorough eye examination. The following will take place:
- During the investigation, the professional will put numbing drops in the eye. These drops help the eye to stay open during the examination.
- He/she may detect an abrasion using a fluorescein eye stain. The test involves the usage of orange or yellow dye and blue light to highlight the injured tissue. This examination can help to uncover an underlying corneal disease.
- Patients at risk of intraocular injury or globe perforation should undergo a CT scan. This action rules out the intraocular foreign body. The professional also seeks to understand the history of the foreign object. He/she might perform a visual acuity test and a thorough slit exam.
Treatment of corneal abrasion is aimed at restoring a healthy epithelium. Treatment is also directed at lessening the pain and preventing infection.
Most corneal abrasions do not require treatment. They are superficial and will often heal on their own. An eye doctor may put antibiotic drops or ointment in the eye. Steroid drops may also come in handy to reduce inflammation. The steroids minimize the possibility of scarring. With time, new cells will grow to replace the damaged ones. It should take 1-3 days for an abrasion to heal in a healthy cornea.
In severe cases, the following will be recommended:
- Patch the eye over a closed eyelid so that the patient is comfortable. A patch helps to reduce pain. It also contributes to faster healing. A patch should not be used for more than 24 hours. However, patches should not be used on abrasions caused by contact lenses. A patch would only increase the risk of infection.
- Prescribe medication to reduce the pain
- Avoid contact lenses during this period. The doctor will advice on a safe time to use them
- Patients should wear sunglasses to reduce the symptoms of corneal abrasion
- Since both eyes move together, it is advisable for the patient to rest the other eye to prevent further pain.
If the abrasion is due to the presence of a foreign body, a surgical procedure may be carried out.
Minor surgery may be necessary to treat the corneal surface in case of erosion. This action prevents recurrences.
A follow-up visit to the doctor is required after surgery. This visit should happen 24 hours after surgery.
Corneal erosion can result from new epithelium that grows after an abrasion is not firmly fastened to the layers below. The erosion sloughs off in the area of the previous abrasion after the abrasion has healed. This often happens when the person wakes up in the morning. It can also occur without trauma to the eye. Corneal erosions are equally as painful.
The patient is advised to contact the doctor if he or she still experiences pain after a corneal abrasion has healed. Repeat patching and using ointments at bedtime can help with recurrent corneal erosion.
Proper care is advised because bacterial infection in the epithelium or corneal ulcers can result. These can lead to loss of vision.
The patient should not rub the eye because it may interfere with the healing epithelium cells.
Individuals are advised to stay away from surroundings where foreign bodies are likely to get in the eye.
Those who work in industrial setups should wear protective glasses.
Contact lens’ users are also advised to take extra precaution.