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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. Some corneal abrasions may form a scar and permanently impair vision.
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 your 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

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 your symptoms. An eye exam will be done. The doctor will look for any foreign objects in the eye. Drops may also be placed in your eye to make you more comfortable. It can also make the scratch more visible under a special light.

Treatment

Minor scratches usually heal within 1-2 days. In some cases, your eye doctor will place a contact lens in the eye to help relieve the discomfort and improve healing. The doctor will likely ask you to come back often to make sure the scratch is healing. You may be referred to an eye specialist for large or deep scratches.
Treatment may include:

Removing a Foreign Object

The doctor will remove the foreign object. 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 as needed

Self-care

Always go to an eye doctor immediately if your eye is bothering you. Steps that you may be to follow include:
  • Do not rub your eye. Rubbing may worsen the abrasion.
  • Moist compresses may help relieve the pain.
  • Do not put your contact lenses back in your eye until you get your doctor's approval.

Prevention

Prevention aims to avoid injury to the cornea. To avoid injuring the cornea:
  • Do not rub your eyes.
  • Wear safety glasses or protective goggles when participating in sports, yard work, construction, or other activities that could injure your eyes.
    • It is best to wear goggles that fully surround your eyes and touch your skin.
    • This protective wear is especially important during work with high-velocity objects, such as hammering a nail or grinding metal.
  • Wash your hands before handling your contact lenses. Clean and wear contact lenses as directed. Never sleep in your contact lenses unless approved by your eye doctor.
If something gets in your eye:
  • Try to flush it out with water. Splash the water so it drains toward the side of your head, not toward your nose and other eye.
  • Do not rub your eye.
  • Call your doctor.
If an object strikes your eye at a fast pace, it can be a medical emergency. Seek medical attention immediately.
If a chemical splashes into your eyes, flush your eyes immediately and call 911.
If you do have eye pain or a foreign object, consider seeing an eye specialist immediately rather than going to the emergency room. However, if you have a severe injury or chemical splash, call 911 or go immediately to the nearest emergency room.

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/

Canadian Health Network http://www.canadian-health-network.ca/

References

Behrman RE, Kliegman R, Jenson HB. Nelson Textbook of Pediatrics. 16th ed. Philadelphia, PA: WB Saunders Company; 2000.

Corneal abrasion. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated August 22, 2012. Accessed December 28, 2012.

Corneal abrasion. American Academy of Family Physician Familydoctor website. Available at: http://familydoctor.org/familydoctor/en/prevention-wellness/staying-healthy/first-aid/corneal-abrasions.html . Updated December 2010. Accessed December 28, 2012.

Rosen R, Barkin R, Danzl DF. Emergency Medicine: Concepts and Clinical Practice. 4th ed. St. Louis, MO: Mosby-Year Book, Inc; 1998.

DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Turner A, Rabiu M. Patching for corneal abrasion. The Cochrane Database of Systematic Reviews . 2006;(2). No: CD004764. DOI: 10.1002/14651858.CD004764.pub2.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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