A corneal abrasion is an eye injury caused by a scratch or scrape on the cornea’s surface. A person’s fingernails, contact lenses, or other foreign objects can all cause a corneal abrasion.
The cornea is the clear, protective dome on the eye’s surface that protects the eye from foreign materials. It also bends and focuses light to help people see.
Reflexes such as blinking and rapid eye closure typically protect the eye from harm. However, some events happen before these defenses kick in, leading to cuts or scrapes on the cornea.
This article explains corneal abrasion, its symptoms, treatment, and healing time. It also explores what a person can do at home and how to help prevent it.
A corneal abrasion is any break or loss in the corneal epithelium or the top layer of the cornea. It is also called a scratched cornea or scratched eye.
- Traumatic: This type is typically the result of mechanical trauma from an external object. Examples include the fingernails or a contact lens.
- Spontaneous: This type is often caused by past structural defects or injuries.
The cornea has many nerve endings that send transmit pain signals to the brain. The pain can range from mild discomfort to intense stabbing pain. Other symptoms include:
- light sensitivity (photophobia)
- excessive tearing
- blurred vision
- presence of a foreign body
- corneal opacity (scarring of the cornea)
- rust ring (a reaction to foreign bodies that contain iron)
- blepharospasm (uncontrollable blinking or eyelid twitching)
A person with a scratched cornea should seek prompt medical attention. An untreated corneal abrasion may become infected and progress into a corneal ulcer.
According to the American Academy of Ophthalmology (AAO), an ophthalmologist may provide the following treatment:
- moisturizing ointments or eye drops that add a soothing layer over the cornea
- antibiotic eye drops to help prevent an eye infection
- eye drops that widen the pupil to help relieve pain
- special contact lenses (bandage contact lenses) to speed up healing and reduce pain
- patching the injured eye to reduce blinking, unless the person wears contact lenses
Minimal abrasions (less than 4 millimeters) typically do not require pain medication. However, a doctor may prescribe over-the-counter medication to address mild to moderate pain. Topical eye drops applied directly to the eye can also provide relief.
If a foreign body is in the eye, a person should visit an ophthalmologist within 24 hours to have it removed. For a foreign body on the surface of the eye, the doctor may use irrigation, a damp swab, or a small needle or forceps to remove the item. For a foreign body that is stuck in the eye, surgery may be necessary.
Drugs called cycloplegics can help relieve light sensitivity.
Most corneal abrasions heal within 1–3 days. A doctor will typically follow up 1–2 days after the injury, especially if the person required foreign body removal.
How to treat at home
A person who believes there is something in their eye may first try to flush it with clean water or saline solution.
It is important to avoid rubbing the affected eye, as doing so may worsen the damage to the cornea.
If a person notices any foreign object on the white of their eye, they may try using a soft tissue or damp cotton swab. They should not attempt to remove the particle if it is directly on the cornea.
People who typically wear contact lenses must not wear them until the injury has fully healed.
A person should seek medical advice if they experience symptoms of a corneal abrasion. It is vital that they contact an ophthalmologist immediately if they notice any of the
- an injury that is larger after 24 hours
- pus discharge
- more than one to two lines of vision reduction, for example, 20/20 to 20/60
- no signs of healing after 3–4 days
Pus in the eye can be a sign of a corneal ulcer. This can be very dangerous and requires immediate medical attention.
If a child will not or cannot open the affected eye after 24 hours, or they experience discomfort doing so, their parent or caregiver should take them to a doctor.
- tree branches
- workplace debris
- makeup brushes
- sports equipment
- sand and other small particles
- damaged contact lenses
Spontaneous corneal abrasions may also occur, particularly in people with recurrent corneal erosion. This typically happens in people who have had past corneal injuries and who experience dry eyes.
A person may notice corneal abrasion when waking up in the morning. This is because the cornea’s outermost layer may not attach tightly to the underlying membrane, causing it to stick to the upper eyelid and break off easily.
People who experience recurrent corneal erosion may wish to apply artificial tears when they first wake up.
According to the AAO, the following tips can help protect the cornea against injuries and abrasions:
- wear eye protection when doing activities such as gardening or DIY projects
- wear wraparound safety goggles when working with wood or steel to protect against high velocity particles
- wear sports goggles when playing sports that involve high speed objects, such as badminton
- keep a child’s fingernails short
- take care when applying eye makeup using a brush
- pay close attention when using tools such as hairbrushes or curling irons
- care for contact lenses correctly, and
avoidsleeping in them
A corneal ulcer is a
Corneal abrasions may temporarily affect a person’s vision, while corneal ulcers can cause permanent vision loss. A person with a corneal ulcer may also experience:
- pus discharge from the affected eye
- ciliary flush (a ring of red or violet spreading from around the cornea)
Scrapes and foreign objects commonly cause corneal abrasions, while the most common cause of corneal ulcers is infection. Infections can begin from a break in the top layer caused by a corneal abrasion, contact lens, or other trauma. This break allows bacteria to enter.
Here are some answers to frequently asked questions about corneal abrasions.
How long does it take a corneal abrasion to heal?
It typically takes
Is corneal abrasion an emergency?
Corneal abrasions are
Signs of serious injury include the presence of discharge, large abrasions, and a decrease in visual acuity.
Does sleeping help with corneal abrasion?
Corneal abrasions are common eye injuries that cause mild to severe eye discomfort and pain. Most of the time, an eye scratch heals on its own after several days. However, a doctor may prescribe antibiotics to help prevent infection, as infection can lead to complications such as corneal ulcers.
A person can help prevent eye injuries by ensuring that they protect their eyes from sudden trauma. This includes wearing protective eyewear while gardening or doing DIY, trimming the nails, and taking extra caution when applying eye makeup.