What are the common causes of corneal abrasions. How can you recognize the symptoms of a corneal abrasion. What are the most effective treatment options for corneal abrasions. How can you prevent corneal abrasions from occurring. When should you seek medical attention for a corneal injury.

Understanding Corneal Abrasions: A Common Eye Injury

Corneal abrasions are among the most frequent eye injuries encountered by adults. These superficial scratches on the cornea, the clear front surface of the eye, can cause significant discomfort and temporarily affect vision. While often minor, corneal abrasions require proper care to ensure swift healing and prevent complications.

What exactly is a corneal abrasion?

A corneal abrasion occurs when the outermost layer of the cornea, called the epithelium, is damaged. This can happen due to various forms of trauma, ranging from a fingernail scratch to contact with airborne debris. The cornea is densely packed with nerve endings, which explains why even small abrasions can cause intense pain and discomfort.

Risk Factors and Common Causes of Corneal Abrasions

While anyone can experience a corneal abrasion, certain factors increase the risk. Understanding these can help in prevention and prompt recognition of the injury.

Who is most at risk for corneal abrasions?

• Contact lens wearers, especially those who wear lenses for extended periods or sleep in them
• Individuals working in dusty, windy, or debris-filled environments
• People engaged in high-risk activities without proper eye protection
• Those with certain eye conditions that may predispose them to corneal injuries

What are the most common causes of corneal abrasions?

Corneal abrasions can result from various incidents, including:

1. Rubbing the eyes vigorously, especially when a foreign object is present
2. Poking the eye accidentally with a finger, makeup brush, or other object
3. Impact from small particles like dust, sand, or metal shavings
4. Improper use or care of contact lenses
5. Injuries from tree branches or plant materials while outdoors
6. Sports-related accidents, particularly in contact sports

Recognizing the Symptoms of a Corneal Abrasion

Identifying a corneal abrasion quickly is crucial for proper treatment and prevention of complications. While the injury itself may not be visible to the naked eye, several telltale symptoms can indicate its presence.

How can you identify a corneal abrasion?

The primary symptoms of a corneal abrasion include:

• A persistent sensation of having something in the eye that won’t wash out
• Sharp, intense pain in the affected eye
• Excessive tearing and watery eyes
• Heightened sensitivity to light (photophobia)
• Blurred or hazy vision
• Redness of the eye and surrounding area
• Involuntary squinting or difficulty keeping the eye open

If you experience these symptoms, especially following potential eye trauma, it’s important to consider the possibility of a corneal abrasion and take appropriate action.

Immediate Self-Care Measures for Corneal Abrasions

While professional medical care may be necessary for corneal abrasions, there are several immediate steps you can take to minimize discomfort and promote healing.

What should you do immediately after suspecting a corneal abrasion?

1. Resist the urge to rub your eye, as this can exacerbate the injury
2. Rinse your eye gently with clean water or saline solution to remove any potential debris
3. If you wear contact lenses, remove them immediately
4. Blink frequently to encourage natural tearing, which can help flush out irritants
5. Use artificial tears to keep the eye lubricated and comfortable
6. Wear sunglasses or stay in a dimly lit area to reduce light sensitivity

These initial steps can provide relief and prevent further damage while you assess the need for professional medical attention.

Medical Treatments for Corneal Abrasions

While many minor corneal abrasions heal on their own within a day or two, medical intervention may be necessary in some cases to ensure proper healing and prevent complications.

What treatments might a doctor recommend for a corneal abrasion?

Medical treatments for corneal abrasions may include:

• Antibiotic eye drops or ointments to prevent infection
• Cycloplegic drops to relieve pain and prevent muscle spasms around the eye
• Oral pain medication for severe discomfort
• In some cases, a special contact lens may be used as a bandage to promote healing
• Follow-up appointments to monitor healing progress

It’s important to note that the use of topical anesthetic drops is typically limited to diagnostic purposes, as prolonged use can slow healing and potentially lead to more serious complications.

Prevention Strategies for Corneal Abrasions

While not all corneal abrasions can be prevented, taking certain precautions can significantly reduce your risk of experiencing this painful injury.

How can you protect your eyes from corneal abrasions?

Consider implementing these preventive measures:

1. Wear appropriate protective eyewear during high-risk activities, such as sports or working with power tools
2. Exercise caution when using makeup brushes, eyelash curlers, or applying contact lenses
3. Maintain proper hygiene and follow recommended care procedures if you wear contact lenses
4. Avoid sleeping in contact lenses, even if they are approved for extended wear
5. Be mindful of your surroundings in windy or dusty environments
6. Trim your fingernails and avoid rubbing your eyes excessively

By incorporating these habits into your daily routine, you can significantly reduce your risk of experiencing a corneal abrasion.

When to Seek Medical Attention for Eye Injuries

While many corneal abrasions heal without complications, certain situations warrant immediate medical evaluation to prevent potential long-term vision problems.

Under what circumstances should you consult an eye care professional?

Seek medical attention if you experience:

• Persistent or worsening pain beyond 24 hours
• Suspicion of a foreign object embedded in the eye
• Chemical exposure or burns to the eye
• Abrasions caused by plant materials or high-velocity impacts
• Recurrence of symptoms days after initial healing
• Presence of discharge, especially if it’s thick or pus-like
• Progressive vision loss or significant blurring
• No improvement with self-care measures after 24 hours

When in doubt, it’s always better to err on the side of caution and consult a healthcare professional for proper evaluation and treatment.

Long-Term Considerations and Potential Complications

While most corneal abrasions heal without incident, awareness of potential complications can help ensure prompt intervention if issues arise.

What are some potential long-term effects of corneal abrasions?

In some cases, corneal abrasions may lead to:

• Recurrent corneal erosion syndrome, where the epithelium repeatedly detaches from the underlying corneal tissue
• Corneal scarring, which may affect vision if located in the visual axis
• Increased susceptibility to future corneal injuries
• Development of corneal ulcers, particularly if the abrasion becomes infected

Regular follow-up with an eye care professional can help monitor healing and address any emerging issues promptly.

How can you promote optimal healing after a corneal abrasion?

To support the healing process and minimize the risk of complications:

1. Follow your doctor’s instructions carefully regarding medication use and follow-up appointments
2. Avoid rubbing your eyes, even as they begin to feel better
3. Protect your eyes from further injury during the healing process
4. If you wear contact lenses, wait until your eye care professional gives you clearance to resume their use
5. Be attentive to any changes in your symptoms or vision, and report them promptly to your healthcare provider

By taking these steps, you can help ensure a smooth recovery and minimize the risk of long-term effects from your corneal abrasion.

Advances in Corneal Abrasion Diagnosis and Treatment

The field of ophthalmology continues to evolve, bringing new technologies and approaches to the diagnosis and treatment of corneal abrasions.

What recent advancements have improved corneal abrasion care?

Several innovations are enhancing the management of corneal abrasions:

• High-resolution imaging techniques for more precise diagnosis
• Development of advanced artificial tear formulations to support healing
• Improved bandage contact lens materials for better comfort and healing
• Research into growth factors and other biologics to accelerate corneal repair
• Enhanced antibiotic formulations to prevent infection more effectively

These advancements contribute to more accurate diagnoses, faster healing times, and better overall outcomes for patients with corneal abrasions.

How might future developments change corneal abrasion treatment?

Looking ahead, potential areas of progress include:

1. Gene therapy approaches to enhance corneal healing capabilities
2. Nanotechnology-based treatments for targeted drug delivery
3. Stem cell therapies to regenerate damaged corneal tissue
4. Artificial intelligence algorithms for rapid and accurate diagnosis
5. Development of smart contact lenses that can monitor corneal health and deliver medication

As research continues, these and other innovations may revolutionize the way corneal abrasions are diagnosed, treated, and prevented, leading to improved outcomes and quality of life for patients.

Corneal Abrasion Condition, Treatments and Pictures for Adults

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).
• Blurry vision.
• Redness of the eye.
• Spasm of the muscles surrounding the eye resulting in squinting.

Self-Care Guidelines

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.

Treatments

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.

Visit Urgency

• 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.

Trusted Links

• MedlinePlus: Corneal Disorders
• MedlinePlus: Eye Injuries
• Clinical Information and Differential Diagnosis of Corneal Abrasion

References

Yanoff M, Duker JS, eds. Ophthalmology. 2^nd ed, pp. 415-416. St. Louis, MO: Mosby, 2004.

Disease Groups:
Common Eye Problems

Last modified on October 10th, 2022 at 3:38 pm

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Corneal erosion – symptoms, diagnosis and treatment

• Symptoms
• Treatment of corneal erosion
• What is recurrent corneal erosion
• Symptoms of recurrent corneal erosion
• Treatment

Corneal erosion is a lesion of the cornea accompanied by loss of the epithelial layer.

Most often, corneal erosion occurs with mechanical damage, chemical and radiation exposure. With erosion of the cornea, rejection or exfoliation of the epithelium in a limited area or on the entire surface of the cornea can be observed. Less common is spontaneous rejection of the epithelium, which is called recurrent erosion.

Symptoms:

• severe photophobia
• lacrimation
• blepharospasm
• sensation in the eye of a foreign body
• redness of the eyeball
• decreased visual acuity
• eye pain

Treatment of corneal erosion

In the event of corneal erosion, as a rule, drugs are prescribed that restore the corneal epithelium, the so-called keratoprotectors, in the form of eye drops and ointments that moisturize the surface of the cornea. Drops are prescribed during the day, and ointment at night, as it has a longer effect.

To prevent infection, an antibacterial drug is prescribed in the form of drops or ointment. After the restoration of the corneal epithelium, and this happens depending on the extent of the defect from 5 to 15 days, drops based on natural tears are prescribed for a long time to prevent the occurrence of recurrent corneal erosion.

Sometimes, as a prevention of rejection of the newly formed epithelium, a soft contact lens is temporarily installed on the affected cornea.

With relapses and ineffectiveness of conservative treatment, phototherapeutic keratectomy (PTK) can be performed. This operation is similar to photorefractive keratectomy (PRK) performed for diseases such as myopia, astigmatism and hyperopia. This technique is performed using an excimer laser to remove the corneal epithelium and influence the Bowman’s membrane to stimulate normal healing.

What is recurrent corneal erosion

Recurrent corneal erosion is a recurring damage to the epithelium, observed when there is a violation in the basement membrane of the epithelial layer of the cornea.

The cornea of ​​the human eye consists of five layers. The outermost layer is called the corneal epithelium, it consists of 5-6 layers of cells, performs a protective function and recovers quite well when damaged. The epithelium is located on the basement membrane, which regulates the restoration of the epithelium and its structure. Below it is Bowman’s membrane – a dense tissue that serves as a support for the epithelium. Deeper than it lies the stroma, which makes up most of the volume of the cornea, which consists of special cells – keratocytes, arranged in a strict order, which ensures the transparency of the cornea. The stroma behind is adjacent to the most durable tissue of the cornea – Descemet’s membrane – a dense membrane that performs a protective function. The last layer, the endothelium, is a layer of one row of cells that act as a pump that controls the exchange of fluid and nutrients between the cornea and the moisture of the anterior chamber of the eye.

Recurrent corneal erosion occurs, as a rule, after trauma to the surface layer of the cornea, that is, corneal erosion, in which the basement membrane of the epithelial layer is damaged. Then, gradually, this defect overgrows and is covered by the epithelium, but since the basement membrane still has an impaired function, erosion also recurs in the future.

In addition, recurrent erosion may occur as a result of a degenerative process in the cornea of ​​the eye.

Symptoms:

• Pain syndrome
• Redness of the eye
• Lachrymation
• Photophobia
• Decreased visual acuity

Treatment

To restore the epithelial layer of the cornea, artificial tear preparations, regenerating gels and ointments are prescribed. Artificial tear preparations and moisturizing drops are prescribed to this group of patients for a long time in order to reduce the likelihood of relapse.

With frequent relapses and ineffective treatment, improvement can be obtained by phototherapeutic keratectomy (PTK). This operation is performed using an excimer laser to remove the corneal epithelium and expose the Bowman’s membrane to promote normal healing.

Erosion of the cornea of ​​the eye: causes, symptoms, treatment

The cornea of ​​the eye assumes the main protective function of the organs of vision and often does not withstand the effects of external factors. Its superficial damage is known in ophthalmology as corneal erosion. The disease is accompanied by focal desquamation of the epithelium – the stratum corneum, which protects the internal structures of the eyes from the aggressive influence of the environment. The resulting sore becomes a “gateway” for infections that can go to the vitreous body, lens and fundus. If left untreated, erosion can lead to irreversible loss of vision.

The structure of the cornea of ​​the eye

The outer shell of the eye or the cornea is a multilayer lens that acts as a screen that protects the organs of vision from mechanical, chemical and thermal influences, and is also the main optical refractive lens. It consists of five layers:

1. Superficial or epithelial – consists of several rows of epithelial cells that are capable of rapidly dividing.
2. Bowman’s membrane is the supporting layer that supports the outer epithelium. It has fewer rows of cells, but they are denser.
3. Stroma is the thickest part of the cornea, composed of keratocytes, providing transparency of the eye membrane.
4. Layer of Desmecetes — corneal framework consisting of epithelium. The toughest and most durable layer. The inner layer – the endothelium, adjacent to the surface of the anterior chamber of the eye, consists of a modified epithelium. It provides metabolic processes between the internal environment of the organs of vision and the outer layers of the cornea.

The disease is characterized by damage to only the outer epithelial layer. However, in some cases, the pathological process affects the deep layers of the membrane, provoking its clouding and infection of the anterior chamber of the eyeball.

Main causes of erosion

Erosion of the outer layer of the cornea can occur against the background of infectious or non-infectious processes. The causes of infection are:

• infection of the membrane of the eye with herpes virus;
• contamination with fungi;
• chlamydia eye;
• bacterial conjunctivitis provoked by Pseudomonas aeruginosa, streptococcus, staphylococcus.

Non-infectious erosion of the cornea is caused by its dystrophy, which develops against the background of a lack of local immunity, traumatic injury. The most common causes of non-infectious forms of the disease are:

• violations of the rules for wearing contact lenses;
• dry eye syndrome;
• foreign objects or chemicals in the eye;
• damage to the cornea during eye surgery;
• eye injuries.

Also, the pathology occurs due to autoimmune diseases, hormonal and endocrine disorders: atopic dermatitis, rheumatoid arthritis, diabetes mellitus, etc. Against the background of these diseases, a recurrent, that is, a recurring pathology, often develops.

Important! Non-infectious and traumatic corneal erosion can be complicated by infection. Since both types require specific therapy, when diagnosing a running process, it is important for a doctor to establish the true causes of the disease.

Symptoms

Clinical manifestations of erosive damage to the cornea are specific, so a preliminary diagnosis can be made already at the stage of patient questioning. The first sign of pathology is acute, sometimes unbearable pain in one eye. It feels like a sharp foreign object or sand getting into the eye. 1-2 days after the onset of the destruction of the cornea, reactive lacrimation occurs, swelling of the eyelids appears, in 80% of cases, patients experience blepharospasm: the inability to open the eye and blink normally.

For infectious erosion, the presence of additional symptoms is characteristic:

• redness and swelling of the mucous membranes of the eye from the first day of the disease;
• discharge from the eye of pus;
• photophobia (increased discomfort when trying to look at a light source).

If the bacteria managed to damage the central part of the cornea, there is a noticeable decrease in visual acuity.

With a recurrent form of corneal erosion, scar tissue forms on the shell, which almost do not transmit light. In addition, erosion in this form of the disease develops into ulcers – deeper foci of corneal dystrophy. In severe cases, they can reach the anterior chamber of the eye and serve as a gateway for infections. This form of the disease most often ends in loss of vision.

Diagnosis

Detailed imaging techniques are used to diagnose erosive damage to the cornea. Eye examination using special tools helps to determine the cause of the ailment:

• detect foreign objects in the conjunctival sac;
• see tumor changes in the mucous membranes;
• to visualize exudate in infectious eye diseases.

After a simple visual examination, an eye biomicroscopy is performed – a detailed examination of the cornea using a special optical device. The procedure helps to visualize erosion, determine its size and the degree of penetration into the cornea.

Good to know! If the doctor sees external signs of erosion, but cannot detect the pathological focus due to its small size, he uses fluorescein, a special dye that “highlights” even microscopic lesions on the cornea of ​​​​the eyes.

To identify the causes of the disease, additional studies are used:

• diaphanoscopy or measurement of intraocular pressure;
• ophthalmoscopy and ultrasound diagnostics to detect intraocular pathologies;
• bacteriological and cytological analyzes of smear from the conjunctiva.

Patients who wear contact lenses will have to have them checked under a microscope. The fact is that they can have microscopic cracks and roughness that can damage the cornea. Based on the data obtained during the diagnostic process, the doctor prescribes treatment.

Methods of treatment

The first step in the treatment of erosion on the cornea of ​​non-infectious origin is the quenching of the defect with a solution of brilliant green or iodine. This prevents the further spread of the destructive process in depth and breadth. With the rapid development of the degenerative process, the doctor can apply laser coagulation of the erosion boundaries.

After cleansing the pathological focus, erosion treatment is continued with the use of physiotherapy:

• ultraphonophoresis – introduction of medicinal solutions into the cornea by means of ultrasonic waves;
• electrophoresis – administration of medicines by means of electric waves;
• magnetotherapy — impact on the eye tissues with a magnetic field.

To accelerate the healing of erosion, keratoprotectors are used – agents that accelerate the regeneration of the epithelial layer of the eye shell. These include drugs “Kerakol”, “Visitil”, “Dacrolux”. They contain hypromellose and organic compounds similar to it, which form a thin film on the surface of the cornea and protect against external influences. In addition, keratoprotectors include compounds that stimulate tissue regeneration and restore blood supply to the organs of vision.

To reduce symptoms, protect the surface of the eye from friction, and eliminate irritation, moisturizing eye drops are used: Systeine ​​Ultra, Vizin, Oftagel and their analogues.

If conservative therapy cannot contain the spread of erosion or the defect rapidly deepens and spreads in breadth, keratoplasty is used – microsurgical restoration of the cornea.

In case of infectious erosion, in addition to the listed drugs, drugs are used that correspond to the identified pathogen: antibiotics, antifungal, antiviral or antiparasitic agents. To weaken the inflammatory process, which necessarily accompanies infectious erosion, apply:

• antihistamines;
• immunomodulators;
• anti-inflammatory drugs.

They are used in the form of ointments, eye drops (instillations), intraocular (parabulbar) injections. The duration of their use depends on the severity of the pathological process.

The erosion of the cornea heals within a few weeks. In its place, scar tissue can form, causing visual impairment. If over time it is not replaced by healthy tissues, a microsurgical operation is performed – laser ablation. An ophthalmologist removes the superficial layers of the cornea, after which healthy tissue is formed in their place.

During the treatment of erosion on the cornea, it is not recommended to use local anesthetics and analgesics. They interfere with healing and can cause thinning of the cornea.

Possible complications and prognosis

With timely detection and adequate treatment, erosion disappears without a trace in 2-4 weeks. Reappearance of the defect or scarring with proper therapy is unlikely.

Delayed diagnosis and treatment are fraught with numerous complications:

1. Corneal neovascularization – the formation of additional vessels penetrating the cornea, which reduce visual acuity.