Corneal Abrasion

Overview

A corneal abrasion occurs when the surface of the eye (the cornea) is either sliced or scraped away by some external force. It is excruciatingly painful because of all the exposed nerve endings and is often accompanied by excessive tearing (epiphora) and a red eye. Corneal abrasions are more common in young, active individuals.

Corneal abrasions can occur as a result of any kind of contact between the eye and some other object (and I'm sure there are some outrageous corneal abrasion occurrences out there!), but some examples include the following: scratch to a mother's eye by her baby (this is actually relatively common), papercut due to flipping of a piece of paper towards the eye, misguided mascara brush, tree branch, and pepper spray exposure.

Recurrent corneal erosion (RCE) is often times an unfortunate long-term consequence to a corneal abrasion. In RCE, the corneal epithelium does not regenerate properly after being abraded or scratched. Recurrent episodes of ocular pain, often occurring in the morning upon waking or after rubbing the eyes), are similar to the pain of a corneal abrasion.

Signs & Symptoms of a Corneal Abrasion

Depending on the depth and the degree of corneal abrasion, as well as the individual tolerance of the patient, the pain can be anywhere from mild to severe. It is often accompanied by epiphora, photophobia, and foreign body sensation. The eye is typically very red and there is a history of some blunt or sharp trauma to the eye.

Detection & Diagnosis of a Corneal Abrasion

Figure: Corneal abrasion. Courtesy of EyeAtlas.com.

An eyecare professional can diagnose corneal abrasion after having viewed the cornea under high-powered magnification in a slit lamp biomicroscope. Using a yellow dye called Sodium Fluorescein and a cobalt blue light in the slit lamp, any breaks in the corneal epithelium can be detected. Such areas of corneal abrasion will appear to fluoresce bright green under the blue light. While the pain can be enormous, the actual abrasion may be quite small: the cornea is one of the most sensitive areas in the entire body - even the tiniest of scratches can produce a lot of pain.

Corneal Abrasion Treatment

As with any situation in which the surface integrity of the cornea is broken, prophylactic antibiotics are administered. Immediate application of salt solution drops are usually the first line of treatment to reduce swelling of the corneal epithelium and to help it to adhere better to Bowman's membrane. Individual treatment of corneal abrasions varies, depending on the severity of pain, the depth of the abrasion, and the occurrence of infection.

Prevention of Corneal Abrasions

Corneal abrasions can be avoided simply by taking care not to put yourself in a situation that may result in trauma to the eye. By simply opting to wear eyeglasses rather than contacts can help to prevent the risk of a corneal abrasion. For anyone who is working with potential flying objects, safety glasses should be worn at all times.

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