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Corneal Abrasion (Scratched Eye)

Corneal abrasion refers to a scratch on the cornea of the eyes. The cornea is a clear dome-shaped protective covering over the iris (coloured part of the eye) and the pupil (small central black circle in the iris) of the eye. Since the cornea plays a significant role in focusing light, an injury to the corneal surface can lead to vision impairment. The disruption of the cornea can be painful as there are several nerve endings under the surface.

Causes

Various situations causing corneal abrasion include:

  • Entry of foreign matter, like dirt, sawdust, sand or ash, blown into the eye and getting stuck under the eyelids
  • Chemical burns
  • Vigorous rubbing of eyes
  • Poorly fitted or improperly maintained contact lenses
  • Bacterial eye infections
  • Accidental poking of the eye with a fingernail or makeup brush
  • Eyes unprotected during surgery, while under general anaesthesia
  • Sports injuries

Signs and symptoms

The symptoms of corneal abrasion do not always occur immediately after the damage; hence, it may be difficult to detect the cause. Signs and symptoms of corneal abrasion include:

  • Pain while closing and opening the eyes
  • Tearing and redness
  • Blurred or loss of vision
  • Gritty feeling in the eyes
  • Light sensitivity
  • Headache
  • Squinting (misalignment of the eyes) due to muscle spasms around the eye

First aid

Immediate steps you can take in case of corneal abrasion include:

  • Rinse the eyes with saline solution or clean water to wash out the foreign particles.
  • Blink your eyes several times to remove the dust particles.
  • Brush away particles under the upper eyelids by pulling the upper eyelids over the lower eyelids.
  • Avoid vigorous rubbing of the eyes and manual removal of objects from the eye.
  • Do not use cotton swabs or other instruments to remove the foreign objects.

Diagnosis

To examine your eye condition, your ophthalmologist will instil eye drops to numb the pain so that you can temporarily keep your eyes open. To see the abrasions more clearly, your doctor will put yellow-coloured eye drops and examine the cornea under cobalt-blue filtered light. Corneal abrasions will appear green on the cornea. Any leftover foreign bodies may also be removed during the examination.

Treatment

Corneal abrasions will be treated based on the diagnosis. Treatment options include:

  • Topical antibiotic eye drops or ointment may be prescribed to prevent infection and steroids or NSAID eye drops to reduce eye pain and inflammation.
  • Eye drops may be recommended to stop muscle spasms and light sensitivity.
  • Your affected eye may be covered with a patch.
  • Tetanus vaccination may be recommended if there are metallic deposits, to prevent infection.
  • Oral pain medications may be prescribed and you may be advised to wear sunglasses to relieve pain when exposed to the sun’s glare.

Uncomplicated corneal abrasions may heal within 1-3 days, but severe abrasions may take longer to heal. You should report to your doctor in case any unusual symptoms occur after healing of the corneal abrasions.

Prevention

Corneal abrasions and eye injuries can be prevented by the following measures:

  • Wearing protective eyewear during sports activities
  • Wearing sunglasses while on outdoor activities to avoid windblown objects or ultraviolet radiation
  • Wearing protective 180-degree eyewear while metal hammering or grinding wheel and special eyewear while welding