Corneal Abrasion

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What is a corneal abrasion?

The cornea is the clear area in the center of the front surface of the eye.  It is the part of the eye through which we see.  When the cornea is scratched or scraped by a fingernail, contact lens, tree branch or other object, the injury is called a corneal abrasion.

How do we know whether someone has a corneal abrasion?

Most people know right away when something scrapes against their eye.  If the eye hurts afterward, it could be a corneal abrasion.  Even a small injury to the cornea can be very painful.

It is important to have any injury to the cornea examined in our office, but particularly if:

  • The pain does not go away.
  • You feel like something is in your eye, even if you cannot find anything.
  • There actually is something in the eye, such as dirt, small particles, a splinter, etc.
  • The eye is very sensitive to bright light.

How is corneal abrasion treated?

Only a doctor can recommend the right treatment for someone with a corneal abrasion. But everyone who has a corneal abrasion should follow one rule: don’t touch or rub your eyes!

We will examine the eye and remove any objects that we find. Anesthetic eye drops will make this procedure more comfortable.

Most of the time, small corneal abrasions will heal in a few days.  Usually, we prescribe eye drops to keep the eye wet and prevent infection.  It is important to use these eye drops as recommended.

Another option for treating a corneal abrasion is a bandage contact lens.  Bandage contact lenses can promote healing and reduce discomfort.  Bandage contact lenses not only protect the eye from external assault, they also isolate the corneal surface from friction during blinking.  Additionally, unlike other protective methods, such as pressure patching, bandage contact lenses allow medication to be easily instilled.

Antibiotic prophylaxis is needed any time a bandage contact lens is used over a corneal abrasion or erosion.  For an abrasion or erosion, topical antibiotics are prescribed  3 or 4 times a day, depending on the topical drug used.

Despite using prophylaxis, it is important to remain vigilant for signs of infection, as infection can lead to corneal scarring and vision loss.

Do corneal abrasions heal completely?

Corneal abrasions usually heal without causing any other problem.  Even after the original injury is healed, however, the surface of the cornea is sometimes not as smooth as before. Some people who have had a corneal abrasion notice that the eye feels irritated again a few weeks after the abrasion heals.

This feeling may be a sign of trouble with the corneal epithelium – the thin layer of cells that is the surface of the cornea.  These cells are important in the healing of corneal abrasions.  Any spot where they do not grow back to protect the surface of the cornea becomes irritated.  When the cells keep growing back and then slipping off again, it is called a recurrent corneal erosion.

Recurrent corneal erosions can cause great discomfort.  If this occurs, we usually restart the abrasion treatment regimen.  In addition, we often prescribe a steroid eye drop and an oral medication, doxycycline.  Recurrent erosions often take months to completely heal, however, episodes of erosion usually become less severe and less frequent over time.

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