• Corneal Abrasion

    (Scratched Cornea)

    Definition

    A corneal abrasion is a scratch on the cornea. The cornea is the clear, front surface of the eye. It is located directly in front of the colored part of the eye.
    The cornea has several layers that help protect the eye.
    The Cornea
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    Causes

    Most corneal abrasions happen as a result of:
    • Dust, dirt, sand, wood slivers, or metal shavings hitting the eye
    • Vigorously rubbing the eye, especially when something is in it
    • A fingernail, tree branch, or other object scratching the eye
    • Wearing contact lenses, especially if the lenses are worn longer than directed or not cleaned properly
    • Not protecting the eyes during surgery—the cornea can dry out if your eyes are not fully shut during surgery
    • Certain eye disorders

    Risk Factors

    Factors that may increase the risk of corneal abrasion include:
    • Having a dry or weak cornea
    • Wearing contact lenses
    • Working in a setting with eye hazards, such as metal working or gardening
    • Participating in sports where accidental eye injuries can occur
    • Bell's palsy

    Symptoms

    Symptoms may include:
    • Pain that may worsen when opening or closing the eye
    • A feeling that a foreign object is in your eye
    • Blurred vision
    • Tearing
    • Redness
    • Sensitivity to light
    • Headache

    Diagnosis

    The doctor will ask about symptoms and medical history. An eye exam will be done. The doctor will look for any foreign objects in the eye. Drops may also be placed in the eye for comfort. They can also make the scratch more visible under a special light.

    Treatment

    Minor scratches usually heal within 1-2 days. Some severe corneal abrasions may form a scar and permanently impair vision. An eye specialist may be needed for treatment of large or deep scratches.
    Treatment may include:

    Removing a Foreign Object

    The foreign object may be removed. This may be done by flushing the eye with saline or by using a cotton swab, needle, or other tool.

    Medication

    Medications may include:
    • Antibiotic ointment or eye drops to prevent infection
    • Pain medications to reduce discomfort

    Self-care

    Eye problems should always prompt a visit to an eye doctor right. Other self-care steps:
    • Do not rub your eye. Rubbing may worsen the abrasion.
    • Use moist compresses to help relieve the pain.
    • Do not wear contact lenses until the doctor says it is okay to do so.
    In some cases, a contact lens will be placed in the eye to help relieve the discomfort and improve healing.
    The doctor will likely monitor the eye on a regular basis to make sure the scratch is healing.
    In some cases, a contact lens will be placed in the eye to help relieve the discomfort and improve healing.
    The doctor will likely monitor the eye on a regular basis to make sure the scratch is healing.

    Prevention

    Prevention aims to avoid injury to the cornea. To avoid injuring the cornea:
    • Do not rub the eyes.
    • Wear safety glasses or protective goggles when participating in sports, yard work, construction, or other activities that could cause injury.
      • It is best to wear goggles that fully surround the eyes and make contact with the skin.
      • This protective wear is especially important during work with high-velocity objects, such as hammering a nail or grinding metal.
    • Always wash up before handling your contact lenses. Clean and wear contact lenses as directed. Never sleep in contact lenses unless approved by an eye doctor.
    If something gets in the eye:
    • Try to flush it out with water. Splash the water so it drains out toward the side of your head.
    • Do not rub the affected eye.
    • Call an eye doctor.
    If an object strikes the eye at a fast pace, it can be a medical emergency. Seek medical attention right away.
    If a chemical splashes into the eyes, flush them right away and call for emergency medical services.
    If there is no eye pain or a foreign object, consider seeing an eye specialist immediately rather than going to the emergency room. However, for a severe injury or chemical splash, call for emergency medical services.

    RESOURCES

    American Academy of Ophthalmology http://www.aao.org

    American Optometric Association http://www.aoanet.org

    CANADIAN RESOURCES

    Canadian Association of Optometrists http://www.opto.ca

    Health Canada http://www.hc-sc.gc.ca

    References

    Corneal abrasion. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 14, 2014. Accessed January 13, 2015.

    Corneal abrasions. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/prevention-wellness/staying-healthy/first-aid/corneal-abrasions.html. Updated December 2010. Accessed January 13, 2015.

    DynaMed's Systematic Literature Surveillance http://www.epnet.com/dynamed: Turner A, Rabiu M. Patching for corneal abrasion. Cochrane Database Syst Rev. 2006;(2):CD004764.

    Revision Information

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