What is corneal abrasion and can it affect my vision?
A diagnosis of corneal abrasion by your doctor can sound scary and complicated at the same time. Before you ask: “What is corneal abrasion?” your ophthalmologist may explain that it simply means a scratched cornea.
According to the American Academy of Family Physicians (AAFP), it is one of the most common eye injuries seen in the emergency room among people of all ages. Abrasions are prevalent among auto workers and are also responsible for 2% of primary care clinic visits. While a scratched cornea is treatable, there is a potential for serious complications or vision loss if it is not treated correctly.
What Is Corneal Abrasion?
A scratched cornea, or scratched eye, generally means there is a scrape on the surface of your cornea. The cornea is that clear outer layer at the front of the eye that protects the eye from dirt, germs, and other harmful foreign particles.
Abrasions may result naturally from a disruption or loss of cells in the epithelium or top layer of the cornea. External factors may also lead to a scraped cornea, which happens quickly before the eyes defense system kicks in. The other corneal layers beneath the epithelium are also prone to damage from anything that penetrates deep into those layers.
What Causes Corneal Abrasion?
In addition to problems with the epithelium, eye abrasions are classified as spontaneous, traumatic, contact-lens related, and foreign-body related.
- Traumatic causes. For example, when makeup brushes, fingernails, tree branches, and debris in the workplace come into contact with and scrape the cornea.
- Foreign particles. Small particles such as sand can scratch the eye, especially if you rub your eyes.
- Contact lenses. Wearing contact lenses for a longer period than recommended or wearing damaged lenses can scrape the eye.
What Are the Symptoms of Corneal Scratches?
A corneal scratch often causes pain or significant discomfort. You may also feel as if there is something in your eyes, particularly if a particle is trapped under the eyelid. Other symptoms that may occur almost immediately letting you know something is wrong include:
- Redness of the eye
- Teary eyes
- Eye soreness
- Pain when blinking
- Sensitivity to light
- Blurry vision
What Are the Risk Factors?
Auto mechanics, woodworkers, and metal workers are more at risk of sustaining this type of corneal injury from small pieces of flying debris. Wearing the wrong contact lenses or lenses torn around the edge increases the risk. People with dry eyes are also susceptible to eye scratches.
Dry eye is a condition where your eyes do not make enough or the right type of tears. A film of tears is needed to lubricate the eyes and keep the surface clear and smooth. The lack of tears often results in a sensation of sand or grit in your eyes, redness, and burning. Rubbing your eyes to get rid of the sensation can lead to scratches on the thin corneal layer.
Corneal Abrasions Treatment Options
Minor abrasions of the corneal epithelium usually heal within one to three days. More severe scratches can take about a week. If necessary, your ophthalmologist will recommend a treatment based on the result of your eye exam. Common treatment options include:
- Lubricating the eyes with eye drops, eye ointment, or artificial tears
- Wearing an eyepatch for a certain period of time. This helps keep you from blinking and prevents the corneal abrasion from getting worse.
- Dilating your pupils to help relieve pain
- Wearing special contact lenses to speed up healing
- Taking over-the-counter or prescription painkillers
- Taking a course of antibiotics to prevent an eye infection
- Your ophthalmologist may attempt to remove a foreign body in the eye using a swab or by eye irrigation to flush the particle out the eye. Immediate removal is necessary to prevent permanent scarring or vision loss.
Your doctor may direct you to return for a follow-up eye exam within 48 hours to re-assess the injury. If the injury doesn't heal properly or completely, it may result in recurrent corneal erosion. In these instances, an amniotic membrane graft may be used to promote quicker, natural corneal healing with minimal scarring. To avoid complications, seek immediate medical attention if the injury appears to have healed but becomes painful again.
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