A scratched cornea usually starts out quite simply – a fingernail poked in the eye, dust or other debris flying into the eye, or even an improperly worn contact lens can all lead to this common eye injury. According to the American Academy of Ophthalmology, “the most common eye injuries are minor scrapes (abrasions), cuts or tears (lacerations), or other irritations that affect only the surface of the eye – the conjunctiva, sclera, or cornea” with injuries to the cornea accounting for about 50% of all “superficial eye injuries.”
Symptoms of a Scratched Cornea
A scratched corneal is very painful. Those who have a corneal abrasion may have any of the following symptoms:
- eye pain
- redness of the eye
- sensitivity to light
- blurred vision
- constant tearing of the eye
- feeling of something in the eye
Minor scratches may resolve themselves in a short amount of time, but those who are experiencing symptoms of a scratched cornea should seek medical attention if the symptoms persist for more than a few hours.
Basic First Aid for a Scratched Eye or Corneal Abrasion
Patients can do some very basic first aid when the abrasion first occurs. Rinsing the eye carefully may help to remove any foreign objects. Gentle blinking may also help to remove any minor irritants. Do not rub the eye or try to remove foreign objects if lodged in the eye, and never use any tools such as tweezers or a Q-tip.
Injuries caused by fingernails can be especially troubling, as the chances for infection are greater due to the germs usually found on the hand and nails. In this case, seek medical attention quickly.
Treatments for a Corneal Abrasion
An ophthalmologist will perform various tests to determine the extent of the abrasion. First, the doctor may use a numbing drop to ease the discomfort. Next, he may use a yellow eye drop called fluorescein, and examine the eye under a blue light with a slit lamp. This will delineate the scratch and let the eye doctor know how large and deep the abrasion is.
The doctor will check vision in both eyes to see if the abrasion has compromised the acuity of the eye. He may also roll the eyelid up to look underneath to see if there is any scarring or roughness that could add to the injury.
Once the extent of the injury has been determined, common treatments include using an ophthalmic sodium chloride solution during the day and a similar ointment at night. This product, Muro 128, is also available in a generic form, in 2% or 5% sodium solutions. It should be noted that this type of product stings significantly when first applied to the eye.
The purpose of this treatment is two-fold. The sodium in these products can be helpful as it encourages healing. Patients typically use the drops as directed during the day and the ointment at night to lubricate the eye and prevent additional injury caused by eye movement during sleep. Using an artificial tears drop, such as Refresh Tears or Optive Sensitive Preservative Free during the day may also be recommended.
Ophthalmologists may also prescribe antibiotic eye drops to avoid the possibility of infection, especially if the injury was caused by something like dirt, a branch, or a fingernail.
Corneal Abrasion Prognosis
Corneal abrasions are painful injuries, so patients may be advised by their doctor to ease the pain with an over-the-counter pain reliever such as acetaminophen or ibuprofen that may also work to eliminate swelling.
Most corneal abrasions heal well, but patients with this type of eye injury run the risk of developing recurrent corneal erosions, or RCEs. This is a painful condition where the injured corneal epithelium, or first layer of the cornea, doesn’t heal properly to the basement layer and is continually worn off by the eyelid during REM sleep. This condition requires a much more aggressive treatment, often an eye laser surgery known as Photo-Therapeutic Keratectomy.
Treating a scratched cornea takes patience and an understanding of the underlying cause. Most abrasions heal well within 24 to 48 hours. Ophthalmologists usually prescribe sodium drops and ointment, antibiotic drops and some type of pain management drugs. Follow-up visits to the doctor are needed to evaluate progress.
Disclaimer: This article is intended for informational purposes only. Those with eye injuries should seek medical attention immediately and follow their doctor’s advice on treatment.
Sources:
American Academy of Ophthalmology. Eye Injuries: Recent Data and Trends in the United States (accessed May 15, 2010).
WebMd.com. Corneal Abrasion (accessed May 17, 2010).
eMedicineHealth. Corneal Abrasion Symptoms. (accessed May 18, 2010.
Johson, Priya. Scratched Cornea Symptoms. Buzzle.com. (accessed May 17, 2010).
National Eye Institute. Facts About the Cornea and Corneal Disease. (accessed May 18, 2010).
