Overview

Corneal abrasion refers to a scratch or injury to the surface of the cornea, which is the clear, protective outer layer of the eye. This condition is quite common and can result from minor trauma, foreign objects, or even improper contact lens use. Corneal abrasions can cause significant discomfort, eye redness, sensitivity to light, and blurred vision. Although most cases are minor and heal quickly, some deeper abrasions can lead to complications like infection or scarring if left untreated. Prompt evaluation and appropriate care typically lead to a full recovery.

Causes

Corneal abrasions can be caused by a variety of physical, environmental, and behavioral factors, including:

• Foreign Objects: Dust, sand, wood chips, or metal particles can scratch the corneal surface.
• Contact Lens Use: Improper contact lens hygiene, overuse, or wearing damaged lenses can lead to corneal injury.
• Eye Trauma: Accidental pokes to the eye with fingers, makeup brushes, or tree branches can cause scratches.
• Dry Eyes: Inadequate tear production can make the cornea more prone to minor injuries.
• Chemical Exposure: Splashes from household cleaners or chemicals can irritate and damage the cornea.
• Rubbing the Eyes: Excessive or rough rubbing of the eyes, especially when a foreign body is present, increases the risk.
• Surgical or Medical Procedures: Certain eye procedures or tests may occasionally cause minor abrasions.

Symptoms

Symptoms of corneal abrasion usually appear rapidly after the injury and may include:

• Eye Pain: Sharp or stabbing pain, especially when blinking.
• Sensation of a Foreign Body: A gritty or scratchy feeling in the eye.
• Redness: The affected eye may appear bloodshot.
• Watery Eyes: Increased tear production is common.
• Blurred Vision: Temporary vision disturbances may occur, especially if the central cornea is involved.
• Light Sensitivity (Photophobia): Discomfort in bright lighting conditions.
• Headache: Eye strain from the injury can lead to headaches.

Diagnosis

Diagnosing a corneal abrasion is usually straightforward and involves:

• Medical History: Asking about recent eye injuries, foreign body exposure, or contact lens use.
• Physical Examination: An eye doctor inspects the eye using a slit-lamp microscope to detect surface defects.
• Fluorescein Staining: A special dye is placed in the eye, making abrasions glow under blue light, clearly outlining the injury.
• Eyelid Examination: The upper eyelid is flipped to check for trapped foreign bodies that could worsen the injury.
• Vision Test: Basic vision tests may be performed to assess the extent of vision impairment.

Treatment

Treatment for corneal abrasion focuses on relieving symptoms, preventing infection, and promoting healing:

• Antibiotic Eye Drops or Ointments: To prevent bacterial infection during the healing process.
• Pain Management: Lubricating eye drops, oral pain relievers, or prescribed medicated eye drops can reduce discomfort.
• Cycloplegic Drops: Used in some cases to relax the eye muscles and reduce pain from light sensitivity.
• Contact Lens Avoidance: Patients are usually advised to stop wearing contact lenses until full recovery.
• Eye Patching (Rare): Previously common, but now rarely recommended as it may delay healing.
• Follow-Up Visit: Follow-up within 24-48 hours ensures proper healing and identifies any complications early.

Prognosis

The prognosis for corneal abrasion is generally excellent with appropriate care:

• Quick Healing: Most minor abrasions heal within 24 to 72 hours without long-term effects.
• Minimal Complications: With treatment, risks of infection and scarring are very low.
• Complete Vision Recovery: Normal vision typically returns once the abrasion heals fully.
• Risk of Recurrence: Patients with dry eyes or improper contact lens use may experience recurrent abrasions (recurrent corneal erosion syndrome).
• Serious Complications (Rare): Untreated abrasions can lead to corneal ulcers, infections, or permanent vision damage in severe cases.

With timely treatment and preventive care, corneal abrasions heal well, allowing individuals to return to normal activities quickly.