Introduction  

A corneal laceration is a cut or a tear to the cornea. It can be a partial or full injury to the cornea. A full thickness corneal laceration is a tear or a cut in the external surface of the globe itself. This means that the injury completely pierces or cuts the cornea causing the eyeball to rupture.

The cornea is the smooth, clear outer covering or lining of the eyeball. It plays a vital role in vision by refracting or bending light entering the eyes.  In so doing, it enables the eye lens to focus on objects, nearby or in the distance.

The cornea also acts as a protective covering or a barrier to protect the eye from germs, dirt, and other invasions. This means that fast moving objects, such as pieces of glass, wood, metal,stones and even blows can cause severe injury to the cornea.

If the cornea is damaged, the resulting scars can affect the individual’s vision. The wounds might distort or block light as it enters the person’s eye and impair vision.

Also Known As

  • Ocular laceration 
  • Laceration of cornea
     

Causes and Risk Factors

Any activity which exposes the eyes to fast moving objects can lead to a corneal injury. Often, corneal laceration is due to an impact or damage from a sharp object flying into the cornea.  It may be as a consequence of activities such as:

  • Chopping wood
  • Trimming grass
  • Grinding metal
  • Carving stone

Risk factors:

  • Males are at a higher risk
  • Young boys are at a greater risk
  • Contact sports such as boxing, football
  • Hazardous activities or occupations like masonry, farming, welding, etc.
     

Signs & Symptoms

The symptoms of corneal laceration may include:

  • Eye bleeding 
  • Tearing
  • Severe or acute eye pain
  • Change in the shape of the pupil
  • Distorted or decreased vision
  • Sensitivity to light
  • The sensation of a foreign body in the eye
     

Diagnosis

An individual experiencing any of the symptoms of corneal laceration should consult an eye care professional without delay. 

He/she will conduct a comprehensive eye examination to find out the extent of the laceration. They will strive to determine whether it is a partial or full thickness injury. 

The professional may apply numbing eye drops to ease the pain. It helps the patient to keep the eye open during the examination of the corneal laceration. A fluorescein eye stain may also be conducted. It is an eye exam which employs a blue light and an orange dye, known as fluorescein, to identify corneal injury or damage.

Treatment 

The treatment focuses on removing any foreign body, repairing corneal damage and preventing loss of vision.

Medical Treatment

The eye doctor may prescribe medication to prevent eye infection and relieve pain.

Surgical Treatment

In most cases, surgery is needed to remove any foreign object, if present, and to repair the cuts. 

Surgery is done to help prevent infection and to seal the cut into the eye. It helps to avoid any further damage to the eye.

Severe corneal lacerations may need more than one surgery to repair. 

After the surgery, the eye is patched to protect it, and the surgeon may also prescribe medication for pain relief and to speed up the healing process.

Home Care

A person experiencing symptoms of corneal laceration should take the following precautions:

  • Not to attempt to remove the object lodged in the eye
  • Avoid rinsing the eye with water 
  • Not to pressurize or rub the eye
  • Avoid ibuprofen, aspirin and anti-inflammatory medication
  • Use a non-contact eye shield to protect the eye until medical attention iis sought
  • See a physician at once
     

Prognosis/Long-term outlook

An patient with a corneal laceration is at a high risk for complications such as scar formation, glaucoma, retinal detachment and infection. Thus, it is a severe injury that needs immediate medical attention.

Severe corneal lacerations might cause permanent loss of vision. Multiple surgeries may also lead to irreversible visual impairment.

It is vital for patients to do follow ups for aftercare after treatment.

Prevention/Follow Up

Careful parenting is essential especially where young boys are involved. It may prevent them from engaging in risky activities.

One should use protective eyewear for hazardous activities and sports.