Corneal Abrasion

What is a corneal abrasion?

A corneal abrasion is a scratch on, or an injury to, the surface of your cornea, the clear covering on your eye. The epithelium is the name of the surface or top layer of your cornea — there are five layers in total.

Other terms for corneal abrasion include scratched eye or scratched cornea.

Although a corneal abrasion isn’t likely to be a serious injury, you should make an appointment with your healthcare provider. If the scratch develops into an infection, it could cause more damage.

What are the signs and symptoms of a corneal abrasion?

Signs and symptoms of a corneal abrasion can include:

• Eye pain.
• The feeling that something is in your eye.
• Watery eyes.
• Blurred vision.
• Red eyes.
• Sensitivity to light (photophobia).
• Swollen eyes or eyelids.

What causes a corneal abrasion?

You can scratch your cornea by getting something in your eye while you’re working with equipment or tools. Things that can get into your eye and scratch it include:

• Dust, dirt, sand or pieces of plants.
• Tiny bits of wood or metal.
• Make-up brushes or applicators.
• Your fingernails.

You can also develop a corneal abrasion from your contact lenses if you:

• Wear your lenses when your eyes are dry.
• Have contact lenses that don’t fit well.
• Use too much force to remove or insert your contacts.

What are the risk factors for a corneal abrasion?

Risk factors for corneal abrasions include:

• Working around eye hazards, like grinding machines or sawmills.
• Landscaping without safety glasses.
• Participating in sports that may cause eye injuries.
• Wearing contact lenses.
• Having dry eyes.
• Rubbing your eyes repeatedly or with too much force.

What are the complications of corneal abrasion?

Corneal abrasions are mostly minor and heal quickly when they’re small. Larger scratches on your eye are more likely to result in complications that could include:

• Keratitis.
• Corneal ulcers.
• Iritis, inflammation of the iris (the circle of color that surrounds your pupil).

Recurrent erosion syndrome, a condition where you can have repeated episodes of eye pain and blurred vision because the top layer of your cornea is breaking down. Another name for this is recurrent corneal erosion syndrome.

How is a corneal abrasion diagnosed?

Your healthcare provider will first ask you questions about your medical history and your symptoms. They’ll probably want to know what you were doing around the time that your eye started to bother you.

What tests will be done to diagnose a corneal abrasion?

Your provider will do a complete eye exam. This includes the slit lamp exam with the microscope that lets your provider see into your eyes. The provider may have to flip your eyelids inside out if they suspect you have something under your eyelids.

The provider may instill a yellow dye called fluorescein into your eye. The dye fills in any breaks in the skin of your eye and helps find abrasions easily.

How is a corneal abrasion treated?

You, or your provider, may start with flushing out your eye with clean water or saline solution. It’s very important to avoid rubbing your eye.

If you have something in your eye, your provider may use a swab or an instrument to remove the particle. They’ll use topical anesthesia (numbing ointment or drops) so it won’t hurt.

Your provider will prescribe medication to prevent infection. These may be antibiotic eye drops or ointment. They’ll let you know how long to use them. You’ll probably be able to stop when you go an entire day without symptoms. If you’re not better after three days, you’ll need to let your provider know.

Some common topical antibiotic options include:

• Erythromycin ointment.
• Ciprofloxacin drops.
• Moxifloxacin drops.

You probably won’t need pain relievers for a very small scratch. But if you do, your provider will probably recommend that you take an over-the-counter (OTC) oral nonsteroidal anti-inflammatory drug (NSAID). In other cases, your provider may prescribe a topical analgesic (pain-relieving eye drops or ointment).

Quite often, providers use a bandage contact lens to allow the abrasion to heal and to reduce pain associated with blinking. In cases where the risk with contact lenses is high, providers may recommend a pressure patch with gauze/tape instead.

Complications/side effects of the treatment

There’s a risk of infection with a bandage contact lens. If you have one, you’ll need to follow up within one to two days for monitoring.

How long does it take to recover from treating a corneal abrasion?

If the corneal abrasion is minor, most people will feel better in 24 to 48 hours. The cells in that part of the eye reproduce very quickly. Larger scrapes may take longer to heal.

If your eye isn’t feeling better after 24 hours, you should contact your optometrist or ophthalmologist.

Can a corneal abrasion be prevented?

You can reduce your risk of a corneal abrasion by doing certain things. These include using protective eyewear and practicing good hygiene with your contact lenses.

When should I use eye protection like goggles or safety glasses?

Use eye protection when you’re:

• Working with chemicals.
• Doing work in the yard, like mowing the grass or cutting bushes.
• Participating in contact sports that involve balls, like baseball, or pucks, like hockey.
• Using machinery like grinders, drills, sanders and welding equipment.
• Doing repair work like carpentry or painting.

How can I lower my risk of corneal abrasion if I wear contact lenses?

You can reduce your risk of corneal abrasion if you wear contact lenses by:

• Cleaning and disinfecting your lenses.
• Not wearing your lenses longer than recommended.
• Not wearing contact lenses when your eyes are very dry. Ask your eye care specialist about lubricating eye drops.
• Not being too rough when you’re having a hard time getting the lenses in and out of your eyes.

What can I expect if I have a corneal abrasion?

Most corneal abrasions heal within a few days and cause no further problems. If you need and get treatment, your vision should be fine.

Eye scratches that don’t heal up or don’t respond to treatment could lead to infections or scarring. Both of these things could cause loss of vision.

How do I take care of myself if I have a corneal abrasion?

When the scratch happens, flush your eye with clean water or sterile saline. Don’t rub your eye. You can try blinking for a bit or keeping your eye completely closed.

It may help to pull your top eyelid over your bottom eyelid, which should make your eye water. This could make any piece of dust or other type of particle come out of your eye.

When should I see my eye care provider?

If you think you have something in your eye and flushing or blinking doesn’t make it come out, you should see your eye care provider for further evaluation. This is especially true if you’re in a lot of pain or you can’t see well.

An optometrist or ophthalmologist should handle removing particles from your eye.

If you’ve followed your treatment recommendations, but your eye isn’t feeling better after 24 hours, call your provider.

Call an eye care provider before going to the emergency room during normal business hours.

You may need to go to an urgent care center or emergency room if you’re unable to contact an eye care provider or if it’s outside of normal business hours in these cases:

• You know that something has pierced your eye.
• You’re in extreme pain.
• You can’t see well or have had a sudden decrease in vision.
• You have fluid coming out of your eye.

What questions should I ask my healthcare provider?

You may want to ask your provider some questions, such as:

• What should I watch out for as I heal?
• Are there side effects or complications related to this treatment?
• Do I need a follow-up appointment?