Corneal Abrasion - Causes, Symptoms & Treatment

A corneal abrasion is a scratch on the cornea. The cornea is the clear, protective window at the front of your eye. It lies directly over the colored part of your eye (called the iris). The cornea has several layers that protect the eye. Some corneal abrasions may form a scar and permanently impair vision. A corneal abrasion is an injury (a scratch, scrape or cut) to the epithelium.

Abrasions are commonly caused by fingernail scratches, paper cuts, makeup brushes, scrapes from trees or limbs, and rubbing the eye. Some eye conditions, such as dry eye, increase the chance of an abrasion. It is comprised of three layers and the membranes that separate these layers. It is very difficult to penetrate past the epithelium or top layer of the cornea. The cornea is normally devoid of blood vessels yet has many sensory nerves. When any trauma to the corneal epithelium occurs, cells are lost or destroyed and pain is immediately sensed. When a corneal abrasion occurs, the conjunctiva, or the white of the eye, turns red, as new blood vessels form and those present enlarge, in an attempt to increase blood flow to the eye as it attempts to bring to the eye those cells needed for the healing of the cornea.

A corneal abrasion heals by the movement of neighboring epithelial cells, which slide over the wounded area, and through a cell division process called mitosis, which fill in the abraded area with new epithelial cells. Within two to three days of trauma to the cornea, these new cells start to adhere to the underlying membrane of the epithelium, called the basement membrane and within seven to eight days the abraded area usually heals completely without scarring.

Causes of Corneal Abrasion

A corneal abrasion is usually the result of direct injury to the eye, often from a fingernail scratch, makeup brushes, contact lenses, foreign body, or even twigs. 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. In some people, the outer layers of the cornea are weak. These people may get a corneal abrasion for no apparent reason.

• Chemicals.
• Blow to the eye.
• Having a dry or weak cornea
• Eye injury.
• Contact lenses.

Signs and Symptoms of Corneal Abrasion

Symptoms of corneal abrasion include pain, photophobia , a foreign-body sensation, and a reflex production of tears . Signs include epithelial defects and edema , and often conjunctival injection, swollen eyelids, and a mild anterior-chamber reaction. The vision may be blurred, both from any swelling of the cornea and the excess tears.

Sign and symptoms may include the following :

• Blurred vision.
• A feeling that a foreign object is in your eye.
• Sensitivity to light.
• Headache.
• Redness.
• Tearing .
• Discomfort in the eye.
• Watery eye.

Treatment for Corneal Abrasion

The cornea has a remarkable ability to heal itself, so treatment is designed to minimize complications. If the abrasion is very small, the doctor might just suggest an eye lubricant and a follow-up visit the next day. Minor scratches usually heal within 1-2 days. Your eye may be patched for improved comfort. In some cases, your eye doctor will place a contact lens in the eye to help relieve the discomfort and improve healing. The doctor may ask you to come back to make sure the abrasion is healing.

• Antibiotic used to prevent infection.
• Antibiotic eye ointment, such as Polymyxin-bacitracin.
• Relief of pain with medication.
• Examination is done after using an anaesthetic.
• In selected cases, other medication such as steroids might be used.

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