A corneal abrasion is a scratch, scrape, or cut off the surface of the cornea. The most common causes are nails, makeup brushes, tree branches, and small particles such as dust or sand. Symptoms that appear can include the sensation of an object being stuck in the eye, red, sore, and watery eyes, blurred and blurry vision, and sensitivity to light.
If the eyes experience these symptoms and there is a history of injury to the eye due to nails or sand, avoid rubbing / rubbing the eyes and immediately see a doctor for an eye examination. Examination of the eye with fluorescein drops can show the part of the cornea that is experiencing abrasion. With proper treatment, the symptoms of a corneal abrasion can disappear within 24-48 hours of the symptoms appearing.
What is Corneal Abrasion?
Corneal abrasion is a condition when the surface of the cornea is scratched [1,2]
Scratches can come from the entry of dust into the eyes, nails when rubbing the eyes, eye makeup brushes, or other foreign objects .
The cornea itself is the part of the eye that does not have blood vessels and is a clear and transparent membrane at the front of the eye that lines the pupil and iris of the eye.
Because it is at the front of the eye, the cornea is the most frequently exposed to foreign bodies and scratches.
When the clear surface of the cornea is accidentally scratched by a foreign object, this is called a corneal abrasion.
Facts About Corneal Abrasion
Corneal abrasion in the United States is the most common eye condition, especially in children .
Boys aged 5-15 years are most at risk of corneal abrasion than girls of the same age .
Corneal abrasion does cause discomfort and pain in the eye, but on average it does not result in permanent eye problems .
Please note that the cornea has several layers consisting of (outermost-inner):
- Epithelial layer
- Bowman’s membrane
- Descemet’s membrane
And the part of the cornea that is most often involved in corneal abrasion is the epithelial layer and Bowman’s membrane, because they make up almost 10% of the cornea.
If the corneal abrasion occurs only on the epithelial layer, the chances of healing are faster and without long term effects.
Meanwhile, if the corneal abrasion penetrates Bowman’s membrane even deeper, the chances of healing will be long.
This is a risk of permanent scarring and impact on normal vision.
Causes of Corneal Abrasion
Corneal abrasion is the most common eye injury because it is a scratch on the cornea of the eye due to the entry of a foreign object.
As mentioned earlier, the result of rubbing the eye, so that the eye hit the nail, the eye makeup brush accidentally hits the cornea, then dust that gets into the eye can cause abrasion to occur.
It’s just that, apart from the dust, nails, and makeup brushes, there are other factors that of course increase the risk of corneal abrasions occurring  :
- Athletes who do not wear eye protection so that their eyes are injured from accidental attacks by other players. Football and baseball athletes are the most susceptible to corneal abrasions.
- Small tree branches to smoke and cigarette ash that gets into the eyes when outside or on the road can also be the cause.
- Use contact lenses that are not careful when installing them, as well as contact lenses that are rarely cleaned.
- Excessive or prolonged use of contact lenses.
- Occupational risks that are often exposed to foreign objects, such as construction and agricultural workers or people who work more outdoors.
- Hobbyists who like to do certain handicrafts or crafts so that the eyes can be easily hit by sharp objects. Gardening, wood carving and sewing are the most susceptible to corneal abrasion.
- Schoolchildren are likely to play with objects that are pointed at the ends, such as pens, paper, and pencils.
- Ultraviolet radiation from street lamps to flashes of light from welds that usually occurs in welders can also increase the risk of corneal abrasion.
- Surgical patients who do not wear protective eyewear may also be at risk of corneal abrasion.
The main cause of corneal abrasion is the entry of a foreign object into the eye and then triggers a scratch on the surface of the cornea. These scratches can come from the nails when rubbing your eyes, the use of contact lenses, the effects of surgery, ultraviolet radiation, dust, and exposure to chemicals or other objects.
Symptoms of Corneal Abrasion
In some cases of corneal abrasion, the symptoms are not immediately felt so that when they realize the symptoms are being experienced, the sufferer has forgotten what happened to his eye.
The following are some of the symptoms of corneal abrasion that can be felt when the scratch has occurred: [1,2]:
- Watery eyes
- Eyes feel sore and sore
- Red eyes
- Feels like something is stuck or something is stuck in the eye
- Blurred vision.
- Increased sensitivity to light
- Pain is generally felt when opening or closing the eye
- The cornea can swell which is what can make vision function decrease
- Nausea (but very rare)
- Corneal abrasion in children makes children more easily and often fussy
When should you see a doctor?
When the redness in the eyes does not fade and the feeling of lump does not subside, immediately consult a doctor, especially if you have been treated with eye drops but they are not effective.
The symptomatic condition of a corneal abrasion can be mistaken for another eye condition, so it needs to be examined in detail.
Some diseases that are similar to corneal abrasion are recurrent corneal erosion, herpes simplex infection, and Acanthamoeba infection.
Symptoms of corneal abrasion are similar to eye irritation in general, the eyes will be red, painful, watery, feels lumpy to blurry vision.
Corneal Abrasion Examination
There are several methods of examination that the doctor will primarily perform on the patient to confirm that the patient’s symptoms are positive for a corneal abrasion.
Physical examination is the most important thing applied by doctors to patients with symptoms that are suspected to be symptoms of corneal abrasion .
The doctor will perform a physical examination of the eye using a special flashlight to check for the presence of foreign objects, sand, dust, or certain forms of injury.
Another way of checking that doctors can do is to give eye drops to relax the eye muscles.
These eye drops are also given with the aim of enlarging the pupil of the patient’s eye so that it can be examined more carefully.
Fluorescein is also usually given as part of the examination to be dropped into the patient’s eye .
The purpose of giving these eye drops is to clarify the surface of the cornea that has been scratched by a foreign object.
- Administration of Corneal Anesthesia
The doctor will most likely give a corneal anesthetic so that the pain in the eye can be reduced temporarily and then the doctor will continue an in-depth examination of the eye
Sometimes after giving the anesthetic, the doctor will also use a type of magnifying glass to be able to see scratches on the surface of the cornea.
Examination of the symptoms of corneal abrasion includes a physical examination of the eye, administration of eye drops to anesthesia for the eye.
Treatment of corneal abrasion
There are two methods for dealing with corneal abrasions, namely the self-administration method and medical treatment by a doctor after examining the eye.
Self-care is a form of first aid that can be done when the eye suddenly feels uncomfortable due to an accidental scratch.
There are several ways to treat corneal abrasions that can be done alone as a form of first aid when symptoms of pain, redness and lump in the eye begin to be felt.
Blink your eyes several times to get rid of small foreign objects that enter your eyes and make your eyes feel lumpy.
Usually, if any dust or sand gets into the eye, this method is quite helpful for restoring the eye condition.
- Using Clean Water to Rinse Your Eyes
Provide approximately a cup or a glass of clean water to rinse the eyes that feel blocked and sore .
Or, it could be that the eye that feels uncomfortable is dipped in the water and blinked so that the foreign body particles can get out of the eye.
As an alternative to clean water, saline water or salt water to rinse the eyes well, so that dirt in the eyes can be removed naturally.
Avoid rubbing and touching the eye, which is uncomfortable or an existing scratch on the cornea can make it worse
Also avoid giving anything to the eyes other than clean water for rinsing or salt water.
- Wearing Sunglasses
When symptoms of a corneal abrasion occur, the eye is generally sore and lumpy, accompanied by a high level of sensitivity to light sources .
Therefore, whenever you want to go outside during the day, make sure to wear sunglasses to protect your eyes.
- Not Wearing Contact Lenses
Contact lens wearers, you should avoid using them until the doctor really allows them to wear them again .
Talk to your doctor about using these contact lenses as long as the corneal abrasion has not healed completely.
After examining in detail the condition of the patient’s cornea, the ophthalmologist will usually provide several treatment solutions, such as the following.
There will be a prescription for eye drops that doctors generally give to moisturize the eyes .
Not only does it provide moisture to the eyes, there is a calm and relaxing effect given by these eye drops on the surface layer of the cornea.
Antibiotic drops are generally prescribed by doctors whose purpose is to prevent the eyes from infection [1,2].
There are times when the ophthalmologist will provide protection for the patient’s eye by covering it with a bandage .
The injured eye is closed so that the patient does not just touch the eye or carry out other activities in the eye area that are at risk of worsening the condition of corneal abrasion.
In contact lens wearers, consult a doctor about what to do while the eye is injured and should not wear contact lenses for a while .
Usually, doctors will provide special contact lenses for patients where with their use, it is expected that the eye recovery is faster.
Usually these contact lenses are also prescribed by doctors so that the pain is reduced.
The potential for healing and recovery of corneal abrasion is only 1-2 days without any scars if the scratches are light and small.
However, if the abrasion condition is large enough, the recovery period can occur approximately 1 week or even up to 3 months.
Corneal abrasion treatment consists of two methods, namely independent treatment (through rinsing the eye using clean water or salt water, not touching the eye, and avoiding the use of contact lenses) and medical treatment (antibiotic eye drops and contact lenses specifically prescribed by a doctor).
Corneal Abrasion Complications
Although a corneal abrasion is not a serious eye health problem and can recover quickly, the risk of complications remains, including:
- Uveitis: The middle layer of the eye or uvea that becomes inflamed due to a corneal abrasion that has not been treated properly
- Infection: Scratches on the cornea of the eye that are not treated immediately can develop into infection, especially if the scratch is deep enough.
- Scars: Minor scratches on the cornea of the eye will not leave a mark on the clear layer of the eye, but if the scratch is deep enough, there is a risk of scarring.
If a corneal abrasion is a deep scratch or is not treated promptly, conditions such as scarring, infection, and uveitis are the most likely complications.
How to prevent corneal abrasion
Because corneal abrasion is a scratching condition on the eye, it can always be prevented, by doing the following: :
- Always wear protective eyewear, especially when doing activities that can harm the eyes; be it sports, gardening, sewing, or doing other activities.
- Trimming nails regularly, especially babies or toddlers because they are the most vulnerable to rubbing their eyes and eventually causing corneal abrasion in their eyes.
- Visiting an ophthalmologist, especially for athletes, to get eye protection solutions when competing and practicing.
- Clean your hands every time you put on contact lenses and put them on carefully and correctly; do not miss, also clean contact lenses well.
Corneal abrasion is a scratch that comes from foreign objects that enter the eye during activities both indoors and outdoors, so providing protection for the eye is the main preventive measure.
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- Anonymous. 2019. Harvard Health Publishing – Harvard Medical School. Corneal Abrasion.
- Kierstan Boyd & Elena M Jimenez MD. 2019. American Academy of Ophthalmology. What Is Corneal Abrasion?
- Image: James Heilman, MD, CC BY-SA 3.0 https://creativecommons.org/licenses/by-sa/3.0, via Wikimedia Commons
- Video: DrER.tv