Corneal abrasions are superficial scratches on the corneal surface and are usually associated with a traumatic injury to the eye, although they can also occur in people who suffer from extreme dry eye. The precipitating trauma can be as minor as incidental contact with a finger or small grains of sand or dust getting into the eye.
Corneal abrasions typically cause immediate pain, photophobia, foreign body sensation, tearing, blurry vision, and blepharospasm.
ICD10CM: S05.00XA – Injury of conjunctiva and corneal abrasion without foreign body, unspecified eye, initial encounter
A corneal abrasion is a scratch or cut (abrasion) of the clear outer layer (cornea) of the eye. Injury (trauma) is the most common cause for corneal abrasions. The most common trauma causes are:
Scratches from fingernails (human and animal)
Foreign objects hitting the cornea (eg, dirt, wood splinters, metal shavings, plants, tree branches, etc)
Excessive rubbing of the eye
Overexposure to ultraviolet light
Arc welding light exposure
Over wearing of contact lenses
Ill-fitting contact lenses
Torn contact lenses
Irregular eyelashes rubbing the cornea or falling off into the eye
A foreign object that gets caught under the eyelid, which then irritates the cornea each time you blink
Abrasions may be caused by airbag deployment.
Other causes include underlying eye conditions, such as:
Inability to fully close the eyelids
Abnormalities of the lid position
Severe dry eye conditions
Severe, chronic blepharitis (inflamed eyelids)
Who’s At Risk
Corneal abrasions are fairly common. Those who wear contact lenses or work in dusty, dirty, windy, or debris-laden areas are more likely to get a corneal abrasion.
Signs & Symptoms
Although it is very difficult to see a corneal abrasion with the naked eye, you have to be suspicious of this if you have experienced any of the causes of trauma mentioned above. Along with that is the unrelenting painful feeling that something is in your eye that just won't wash out, plus:
Lots of watery tearing
Sensitivity to light (especially bright light)
Redness of the eye
Spasm of the muscles surrounding the eye resulting in squinting
Most simple corneal abrasions will heal on their own within a day or two at most. Other things that help include:
Keeping the eye shut
Never rubbing the injured eye
Immediately removing a contact lens; contact lens wearers should always have a back-up pair of glasses for when contact lenses shouldn't be worn.
Using artificial tears to bathe the eye
Using clean water to rinse the eye and wash out suspect foreign matter
Using sunglasses to reduce light sensitivity
There are precautions that you can take to prevent getting a corneal abrasion. These include:
Wearing protective eyewear for all conditions that might result in a corneal abrasion, such as working around the garden, working on grinding machines, etc
Being extra careful when using makeup brushes and curling irons
Taking excellent care of and using excellent hygiene with contact lenses
Never sleeping in contact lenses, regardless of manufacture notes
Note: If the corneal abrasion heals and then suddenly recurs days later, this may be a sign of recurrent erosion, which requires specific medical care by an eye care professional. Use of topical anesthetic solutions is only for purposes of diagnosis. Using these drops more than once or twice is dangerous because it slows healing and could lead to more serious conditions.
When to Seek Medical Care
Persistent pain beyond the first day or pain that is increasing despite self-care
You suspect that a piece of metal, wood, or plant material hit the eye with high speed and may have penetrated the eye, not just irritated it.
Any abrasion caused by chemicals, heat burn, makeup brushes, or plant materials
You suspect that a foreign object really is stuck in your eye.
Recurrence of the pain and other symptoms days after the initial injury
Mucoid or pus-like discharge
No improvement with self-care after 24 hours
Progressive vision loss
After assurance that there is nothing more serious than an abrasion, your doctor will check for any foreign objects and, if needed, clean the area. Numbing eye drops or oral pain medication may be given. Topical antibiotics also may be used. Patching is no longer recommended because it could delay healing. If there is an underlying basis for the abrasion, care for this is needed to prevent recurrence. If the abrasion was contact-lens-related, you may be required to be reevaluated regarding your contact lenses as to fit and type. If the problem is recurrent erosion, your doctor will begin specific treatment for that condition.