Corneal Abrasion

A scratch on the epithelial surface of the cornea is called a corneal abrasion. With appropriate treatment for this common eye injury, the prognosis is usually good.

Causes

Many things can cause a corneal abrasion, such as sand, dust, dirt, wood or metal shavings that get in your eye. The cornea can also be scratched by a fingernail, a tree branch or a contact lens. Rubbing your eyes very hard is another way that an abrasion can occur. Sometimes, if a corneal abrasion hasn't healed properly, it can come back weeks or months after the original injury. In some people, the outer layers of the cornea are weak. These people may get a corneal abrasion for no apparent reason.

Symptoms

The following are the most common symptoms of a corneal abrasion. However, each child may experience symptoms differently. Symptoms may include:

• pain and redness in the eye
• tearing of that eye
• pain when the child looks at a light
• excessive blinking in the affected eye
• a younger child may hold that eye shut

The symptoms of a corneal abrasion any resemble other eye conditions or medical problems. Always consult your child's physician for a diagnosis.

Diagnostic tests

After staining with fluorescein, the injured area of the cornea appears green when illuminated by a flashlight. Slit-lamp examination discloses the depth of the abrasion.

Treatment

A deeply embedded foreign body requires removal with a foreign body spud after anesthetizing the cornea with a topical agent. A rust ring on the cornea can be removed with an ophthalmic burr after applying a topical anesthetic. When only partial removal of the rust ring is possible, the eye is left alone to allow reep­ithelialization, which lifts the rust ring to the surface, allowing complete removal the next day.

Additional treatment includes instilling broad­spectrum antibiotic eyedrops in the affected eye every 3 to 4 hours.

Prevention

Everyone should wear eye protection whenever this is recommended. This should be standard practice when using power tools and playing certain sports. Goggles should even be worn when mowing the lawn, because a twig can be thrown upward toward the face. Contact lens wearers should be careful to follow their doctors' instructions on caring for and wearing their lenses. Ill-fitting or dirty lenses could lead to an abrasion, so patients should go for their prescribed checkups.

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