Corneal abrasion

Eye Care Instructions for a Corneal Abrasion (Scratch)

 

What is a corneal abrasion?
A corneal abrasion is a scratch on the skin of the eye (like an abrasion of the skin) and is very painful as the nerve endings in the cornea are exposed. The layer of the epithelium over the cornea is removed and so the cornea is now exposed to infections, such as corneal ulcer, that can lead to permanent scarring and decrease in vision. People using contact lenses are especially at risk if they sleep with their lenses in. Once scratched, the cornea heals quickly by growing healthy tissue to cover the scratch. This acts to preserve the focusing power of the eye and to keep germs or other debris out of the eye. Mild abrasions usually heal quickly, sometimes even in one day depending on the size.  
Deeper or larger scratches can involve Bowman’s layer and can involve the corneal stroma which can increase the risk of repeat abrasions as the anchoring filaments in the Bowman’s layer could be lost. These abrasions may take a week to heal.

 

What causes a corneal abrasion?

• A corneal abrasion can be caused by injury to the eye, such as
• Having debris, such as sand or dust, enter the eye
• Getting poked in the eye
• Being hit in the eye
• Rubbing the eye too hard, wearing contact lenses for too long, or incorrectly putting in or removing a lens may scratch the cornea.
• Some infections in the eye can make it feel like your eye has an abrasion or scratch.

What are the signs of a corneal ulcer?
A corneal abrasion can be painful and may cause

• A feeling that there is something in the eye that won’t come out
• Tears to form in the eye
• Blurred vision or loss of vision
• Eye pain, especially when in sunlight or bright indoor light
• The muscles surrounding the eye to spasm or twitch, causing squinting

Treatment

• Antibiotic drops/ointment
• Pressure patch/bandage contact lens
• Daily exams until the abrasion has healed (be sure to look out for infection). The cornea is poorly supplied with blood vessels so it is easier for infections to occur once the epithelium is removed, especially if it involves dirt or foreign body, such as a tree branch etc.