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A corneal abrasion (scratched cornea or eye) is a very common eye injury. A scratched cornea often causes significant irritation, tearing, discomfort, red eyes and sensitivity to light. Corneal abrasions result from a disruption or loss of cells in the top layer of the cornea, the corneal epithelium. A healthy cornea is essential for good vision. The cornea is the clear front surface of the eye and part of its function is to focus light, enabling you to see clearly. In addition to disrupting vision, a scratched cornea makes your eye more susceptible to infection. As a result, it is important that you see your eye doctor or visit an emergency room or urgent care center as soon as possible if you suspect that your cornea has been scratched.
There are unlimited ways to scratch the corneal surface. Regardless of size, anything that makes contact with the surface of your eye can cause injury and infection.
Some common examples are tree branches, paper, makeup brushes, a pet, a finger, finger nails, workplace debris, metal/wood chips and sports equipment. Some corneal abrasions can be caused by sand debris and other small particles, especially if you rub your eyes while they are still on the surface of the cornea,, which can cause increased damage. If treated right away, most corneal abrasions result in a full recovery as the cornea has the ability to regenerate under the right circumstances. However, untreated abrasions can lead to severe vision loss.
The cornea is rich in nerve endings which makes it extremely sensitive, so even a very small corneal abrasion can be extremely painful and feel much larger in size that it actually is. In addition to pain and a gritty or foreign body sensation, other common symptoms include redness, tearing, light sensitivity, blurred vision, eye twitching and occasionally a dull ache or headache. If you think you may have suffered from a scratched cornea or eye and are experiencing any of these symptoms, seek medical attention right away. At Vue Vision, we are happy to accommodate same-day walk-in appointments for any ocular emergency.
Often People tend to rub their eyes when they feel like something is "in" them, but this can make matters much worse. If you get something stuck in your eye, you can attempt to flush it out with water, but avoid rubbing your eyes as this can inflict further corneal damage. If possible, try to rinse your eye with a sterile saline eye wash or a multipurpose contact lens solution rather than tap water or bottled water. Microorganisms found in tap water and even bottled water can cause a serious vision-threatening infection if introduced to an eye with a scratched cornea. After flushing the eye, seek immediate medical attention because corneal abrasions can cause serious harm in as little as 24 hours. To diagnose a corneal abrasion, our optometrist may apply an eye drop to numb your eye so you can keep it open for the exam. Another type of eye drop, called fluorescein, will be used to help our doctors see the extent of the abrasion using a specialised microscope called a slit lamp, which is only found in an eye doctor’s office.
Depending on what may have caused the scratch and the size/location of the abrasion, our doctors will decide on the appropriate treatment plan. Minor abrasions sometimes can be treated with non-preserved lubricating drops to keep your eye moist and comfortable while your eye's natural healing process takes place. As a precaution, even minor abrasions may be treated with antibiotic eye drops to prevent infection during healing. Superficial corneal abrasions tend to heal quickly, usually within 24-48 hours if a proper treatment plan is in place. Some corneal abrasions may require an antibiotic ointment that stays on the eye longer and a steroid treatment to decrease inflammation, scarring and pain. Large, deep corneal abrasions take longer to heal and can cause permanent scarring that may affect your vision indefinitely. If left untreated, some deep corneal abrasions can lead to a corneal ulcer, which can cause severe vision loss. Abrasions caused by organic matter also increase your risk of corneal ulceration. In some cases, especially with larger abrasions, our doctors may decide to use specialised bandage contact. When used with prescription eye drops, these special lenses provide pain relief and sometimes can speed up healing. Typically, regular contact lenses should not be worn over a corneal abrasion because of the increased risk of an infection developing under the lens. If you are a contact lens wearer, our eye doctors will advise you when it is safe to resume wearing your contacts. Depending on the treatment and severity of the abrasion, our eye doctors may schedule a follow-up exam as early as 24 hours after the initial treatment. Attending this appointment, if scheduled, is paramount as the risks of sight loss can increase drastically within the first 24 hours.
Although some causes of corneal abrasions are difficult to prevent, many can be avoided by taking some simple precautions. Always wear safety glasses or protective goggles in work environments with airborne debris, particularly in welding environments, or when doing yard work, using power tools and playing sports. If you experience a corneal abrasion that appears to be related to dry eyes, book an appointment for a detailed evaluation of the front surface of your eyes and, if necessary, follow the dry eye treatment protocol our doctors may have already recommended based on your past history. If you wear contact lenses, always follow your eye doctor’s advice regarding how long to wear them, when to discard them, how to properly handle them and how to use contact lens care solutions to help reduce the risk of corneal complications while using contacts.