Corneal Abrasion Symptoms & Treatment

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What is Corneal Abrasion?

A corneal abrasion occurs when you get a superficial scratch on the cornea. The cornea is a transparent and protective layer that sits on the eyeball. 

The cornea is also an area filled with many nerve fibers. This means that anything that disrupts the layer could cause pain or irritation. 

If you have a corneal abrasion, your eye may have come in contact with:

  • Dust 
  • Dirt
  • Sand
  • Wood shavings
  • Metal particles 
  • Twig, tree branch, or other plant matter (like a pine needle). 

In general, corneal abrasions are not serious or life-threatening. Many minor corneal abrasions will heal within 1 to 2 days. However, if you do not care properly for the eye injury, you risk experiencing delayed inflammation inside the eye (iritis) or developing a corneal ulcer (an infection otherwise known as keratitis).  

keratoconus graphic

If you believe you have a corneal abrasion and are not sure about its severity, you can visit your local eye clinic and speak with an ophthalmologist. 

Corneal Abrasion Symptoms

The cornea holds many nerve cells called pain receptors. When something scratches the eye, these cells emit the sensation of pain and lets you know of possible ocular surface damage. 

Additionally, corneal abrasions will cause symptoms, including:

  • Foreign body sensation (feeling that an object is lodged in the eye)
  • Painful, watery eyes
  • Eye redness
  • Blurred vision
  • Hazy vision
  • Light sensitivity

Your cornea has at least a hundred times more pain receptors than those in your skin. 

What Does Corneal Abrasion Look Like? 

A simple corneal abrasion is a superficial scratch to the corneal layer. Because it can cause irritation and inflammation, the sclera (white part of the eye) may turn red. 

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Also, if there are doubts about whether you have a corneal abrasion or not, a healthcare professional may perform a diagnostic test using a dye. The dye will illuminate the scratched area. 

Corneal Abrasion vs. Ulcer

A corneal abrasion is not the same as a corneal ulcer. However, a corneal abrasion may result in a corneal ulcer. 

A corneal ulcer (also known as keratitis) refers to an open sore on the cornea. It develops when you either have an eye infection or suffer from severe dry eye or other eye disorders. 

Eye infections can occur in a corneal abrasion, as damage to the cornea leaves it exposed to viruses, bacteria, or fungi. For this reason, an ophthalmologist may prescribe preventive antibiotic eyedrops when you have a corneal abrasion to minimize the likelihood of that event. 

Keratoconus

Additionally, while a corneal abrasion is minor in most cases, a corneal ulcer may cause severe eye health problems. If you have a corneal ulcer, you should seek medical attention immediately to receive proper treatment. 

If left untreated, corneal ulcers can harm your vision and result in permanent vision loss.

What Causes Corneal Abrasion?

Corneal abrasions can occur for different reasons. 

For example, you may get a corneal abrasion from the following list:

  • Tree branches
  • Make-up brush
  • Workplace debris 
  • Airborne debris
  • Sports equipment
  • Sand or other small particles 
  • Foreign objects
  • Prolonged use of contact lenses
  • Damaged contact lenses

You must remember that if you get sand or something small in your eye, do not rub it. Rubbing can worsen the problem and make it easier for a corneal abrasion to take place. Instead, you should wash the eye out with a saline solution or water.

Some people may confuse corneal abrasion with corneal erosion. Both conditions are painful and can cause blurred or hazy vision. However, the latter occurs because the epithelium (layer of cells that run across the cornea surface) naturally begins to break free from the underlying layer.

Is a Corneal Abrasion Serious?

Most corneal abrasions are minor, healing within 1 to 2 days. However, if you are having trouble recovering from a corneal abrasion, you should seek immediate medical care. 

If you do not receive proper treatment, a corneal abrasion can lead to a corneal ulcer. 

It is also important to know that corneal abrasions can be less severe if you avoid the following actions:

  • Try to get rid of an object lodged in the eyeball 
  • Rub the eye after an injury
  • Touch your eyeball with cotton swabs, tweezers, or other items
  • Wear contact lenses while your eye is healing

When to See a Doctor for Treatment

In some cases, you may need to see an eye doctor for treatment. 

You should seek medical care if you experience any of the following after an eye injury:

  • Eye pain
  • Change in vision (e.g., decreased vision)
  • Increased light sensitivity
  • Foreign object in the eye or around or under the eyelid
  • High-speed or high-force eye trauma

How is Corneal Abrasion Diagnosed?

You may have indications of corneal abrasion with pain or redness in the eye. However, it is difficult to see the scratch. Therefore, an ophthalmologist will use a slit-lamp biomicroscope to shine a high-powered light source into the eye and identify any surface scratches. 

The ophthalmologist may also use a special dye and light to diagnose a corneal abrasion. Inserting a fluorescein dye into the eye, the doctor uses a cobalt blue light to contrast the green-appearing scratch marks

How to Treat a Corneal Abrasion

In these cases, you may choose a treatment plan from below:

  • Place moisturizing eye drops or ointment for pain relief
  • Take prescribed topical antibiotics in eye drops or ointment form
  • Insert special dilating eye drops for pain relief
  • Special contact lenses to speed up the healing process and reduce pain
  • Take oral analgesics (pain medication), including topical NSAIDs like ibuprofen

Aftercare & Follow-Up Treatment

Most corneal abrasions are minor. However, it is important to follow up with a specialist. A proper eye examination can confirm adequate healing of the area and that no infection has arisen. 

Additionally, to prevent future eye injury incidents, you should wear protective eyewear like plastic safety glasses. Eye protection can minimize the likelihood of minor abrasions in the eye. 

How Long Does it Take for Corneal Abrasion to Heal?

If the injury is minimal, it will heal completely in approximately 24 to 48 hours. A larger, scratched cornea may undergo an extended healing process (about a week).

Deeper scratches can result in corneal scarring that affects the vision. If severe enough, the condition may warrant a corneal transplant.  

How to Prevent Corneal Abrasions 

To avoid getting a scratched cornea, you should:

  • Wear safety goggles or other eye protection, especially when working outdoors or with wood or metals
  • Clip children and pets’ nails 
  • Be careful with eye makeup or other beauty products when applying 
  • Follow care instructions for contact lenses

Common Questions & Answers 

How painful is a corneal abrasion?

This condition can be painful. The area has the highest densities of nerve endings (more than those on the skin). 

Is a corneal abrasion an emergency?

If you experience trauma to the eye, are in significant pain, or have trouble seeing, you should visit the emergency department. 

Although most eye scratches will be minor and heal on their own, you may want to visit an eye doctor to confirm proper, timely healing. 

What medication is used for corneal abrasions?

Your eye doctor may prescribe moisturizing eye drops or ointment, topical antibiotics, or special dilating eye drops. These medications aim to help reduce pain, decrease inflammation, and lessen the risk of infection. 

What is the fastest way to heal a scratched eye? 

Like any injury, the fastest way to recover is to rest. You should keep your eye closed while the eye is healing as much as possible. You should also follow the doctor’s care instructions and take any medication prescribed to prevent possible infections. 

Can a corneal abrasion heal itself?

Yes. If it is minor, the abrasion should heal within 1 to 2 days. If it is larger, the healing process may take up to a week. 

Does sleep help a scratched eye?

Yes. It does. Sleep allows the body to rest and restore immune defenses. Additionally, closing your eyes will minimize irritation to the injured area. 

Why is my corneal abrasion not healing?

Your original injury may have healed. However, scarring may have appeared, and the epithelium is causing irritation. You should speak with your eye doctor to see if you are experiencing corneal erosion. 

What is the best at-home corneal abrasion treatment?

It is important to rest your eyes. You may also want to use a saline solution to keep the eyes moist. Finally, you should avoid rubbing or wearing contacts to prevent further inflammation. 

Why does my corneal abrasion still hurt months later?

You may be experiencing recurrent corneal erosion. This occurs when the cells in the epithelium (thin layer on the cornea) form and repeatedly break free from the area. This condition can cause discomfort, and you may need to stop wearing contact lenses. Surgery may also be an option to resolve the issue. 

In any case, you should speak to your eye doctor and undergo a complete eye examination to determine the root cause. 

Resources
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Boyd, Kierstan. “Corneal Abrasion and Erosion.” American Academy of Ophthalmology, 17 Sept. 2020.

Corneal Abrasion (Scratch): First Aid.Mayo Clinic, Mayo Foundation for Medical Education and Research, 19 June 2020.

Corneal Abrasion (Scratched Eye): Diagnosis & Treatment.Cleveland Clinic.

Corneal Abrasion.Yale Medicine, Yale Medicine, 24 Oct. 2019

Domingo, Emilissa. “Corneal Abrasion.StatPearls [Internet]., U.S. National Library of Medicine, 12 July 2020.

Wilson, Stephen F, and Allen R Last. “Management of Corneal Abrasions.American Family Physician, 1 July 2004.

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