Our eyes are delicate and complex organs that require proper care and protection. Unfortunately, corneal abrasion symptoms- a common eye injury – can occur in the blink of an eye, causing discomfort and even vision loss. But fear not! This comprehensive guide will teach you to recognize, treat, and prevent corneal abrasions, ensuring your eyes remain in optimal health.
Key Takeaways
- Corneal abrasion symptoms are commonly caused by trauma, foreign objects, or contact lenses and can be treated with topical antibiotics.
- Recognizing the symptoms of a corneal abrasion helps obtain proper treatment and accelerate recovery.
- Prevention strategies for corneal abrasions involve wearing protective eyewear made from polycarbonate material, proper contact lens fitting and eliminating potential risks.
Table of contents
Understanding Corneal Abrasions
Various factors, including trauma, foreign objects, and contact lenses cause most corneal abrasions. These common eye injuries, such as traumatic corneal abrasions, result in discomfort, redness, and light sensitivity, affecting overall well-being. The good news is that corneal abrasions generally have a positive prognosis if treated promptly, with most healing within two to three days. However, larger abrasions may take four to five days to heal.
Should you suspect a corneal abrasion, your first step should be to flush your eye with clean water or sterile saline solution, abstain from rubbing your eye, especially the upper eyelid, and consider seeking medical attention. Under certain circumstances, like when an object is stuck in the eye and cannot be dislodged by flushing or blinking, consulting an eye care provider for further evaluation becomes paramount.
Recognizing the Symptoms
Corneal abrasions, also known as scratched cornea, can manifest a variety of symptoms, including:
- Discomfort
- Blurred vision
- Difficulty opening the eye
- Sensitivity to light
- Foreign body sensation in the affected eye
These symptoms typically appear within 24 to 72 hours of the injury. The severity of pain can vary from mild discomfort to intense, stabbing-like pain, and may also be accompanied by redness, tearing, and sensitivity to light.
Recognizing these symptoms promptly can aid in obtaining proper treatment and accelerating recovery. So, the next time you experience eye discomfort, observe any additional symptoms and contact an eye care professional if necessary.
Proper Diagnosis Techniques
Diagnosing corneal abrasions involves a comprehensive eye examination, which may include fluorescein staining and using a biomicroscope. This process allows the eye care professional to evaluate the extent of the injury and identify any foreign objects that may be present in the eye. Featuring both a microscope and a bright light, the biomicroscope, or slit-lamp biomicroscope as it is also known, allows for an in-depth examination of the cornea during a standard eye exam.
If a foreign object is discovered during the examination, an optometrist or ophthalmologist will be responsible for its removal. While the exact duration of the diagnosis process cannot be specified, corneal abrasions diagnosed generally heal within 24 to 72 hours.
Effective Treatment Options
When it comes to having corneal abrasions treated, the current recommendations emphasize the use of topical antibiotics, pain management, and bandage contact lenses to help corneal abrasions heal. Eye patching is no longer recommended, as it is less effective in promoting healing.
Topical Antibiotics
Topical antibiotics, such as antibiotic eye drops or ointment, are often used to treat corneal abrasions. Doctors often prescribe antibiotic eye drops to prevent infection and promote healing. An anti-pseudomonal antibiotic, such as ciprofloxacin (Ciloxan), gentamycin, or ofloxacin (Ocuflox), is recommended for contact lens wearers. One should refrain from wearing contact lenses until full abrasion healing and completion of the antibiotic course to prevent additional irritation or damage to the cornea.
It is recommended to discontinue therapy entirely if the eye remains symptom-free for 24 hours. Make sure you closely monitor symptoms in the following days. However, if symptoms persist beyond three days, it is advised to seek evaluation from an ophthalmologist.
Pain Management
Pain relief is a primary concern for patients with corneal abrasions. Topical nonsteroidal anti-inflammatory drugs (NSAIDs), such as diclofenac (Voltaren) and ketorolac (Acular), are moderately effective in reducing discomfort. These medications, along with eye lubricants, are suggested for pain management. It is important to avoid using topical corticosteroids, as they should not be utilized for this purpose.
The choice of oral analgesic therapy should consider the patient’s characteristics, as pain relief is the primary concern.
Bandage Contact Lenses
Bandage contact lenses can be utilized to:
- Protect the damaged cornea and foster healing
- Provide analgesia
- Act as a barrier to further epithelial disruption and corneal nerve stimulation
- Protect the cornea from external environmental conditions and counteract the abrasive effects of the patient’s eyelids.
Various types of bandage contact lenses, such as therapeutic and soft contact lenses, can be employed in treating corneal abrasions.
The procedure for applying bandage contact lenses entails the following:
- Positioning a soft bandage contact lens on the cornea to safeguard the wound and promote healing.
- The contact lens should be worn for several weeks to months, with regular replacement every 2 weeks.
- Before applying the bandage contact lens, verifying that the cornea is not infected is of utmost importance.
Potential Complications
Untreated or improperly treated corneal abrasions may result in complications such as ulcers, bacterial keratitis, recurrent erosion syndrome, and traumatic iritis, which can potentially lead to permanent vision loss. Bacterial keratitis, an infection of the cornea caused by bacteria, may develop if bacteria gain access to the eye through the abrasion. Unaddressed corneal abrasions can also result in the emergence of eye ulcers, which can cause corneal scarring, vascularization, perforation, glaucoma, and irregular astigmatism.
Recurrent erosion syndrome may present as a complication of corneal abrasions due to inadequate adhesion of the corneal epithelium to the underlying stroma, leading to episodes of corneal erosion and recurrent symptoms. Traumatic iritis, an inflammation of the iris that occurs after blunt trauma to the eye, can also develop as a consequence of an inadequately managed corneal abrasion.
Prevention Strategies
Preventing corneal abrasions involves taking precautionary measures, such as:
- wearing protective eyewear during hazardous activities
- ensuring the correct fitting of contact lenses when you wear contact lenses
- eliminating potential risks like low-hanging branches
The most effective types of protective eyewear are those made from polycarbonate material, which are resistant to shattering and offer UV protection. One must refrain from using prescription glasses as protective eyewear, instead opting for goggles or safety glasses specifically designed for eye protection.
Proper contact lens fitting assists in avoiding corneal abrasions by ensuring that the contact lens is situated directly on the cornea and adheres suitably to the eye’s surface. This prevents the lens from shifting around easily and decreases the likelihood of shearing force and epithelial disruption that can cause corneal abrasions.
Follow-up and Referral Guidelines
Patients with corneal abrasions should be re-evaluated within 24 hours, with additional follow-ups for contact lens wearers if their symptoms do not improve within a few hours of lens removal. If the abrasion has not healed completely, an additional evaluation should be conducted three to four days later. Patients should be referred to an ophthalmologist in cases of deep eye injuries, foreign bodies that cannot be removed, and suspected recurrent corneal erosion.
Ophthalmologists are pivotal in the follow-up care of corneal abrasions, as they provide examination, management, and continued follow-up post-initial treatment. They ensure the corneal abrasion is healing adequately and monitor for potential complications or infections.
Coping with Recurrent Corneal Erosion
Recurrent corneal erosion may arise if the injury does not heal correctly, necessitating further treatment and surveillance to forestall long-term harm and visual impairment. This condition can be caused by:
| Causes of Recurrent Corneal Erosion |
|---|
| A previous corneal abrasion |
| Epithelial basement membrane dystrophy (EBMD) |
| Normal aging |
| Autoimmune diseases |
| Medicamentosa |
| Eyelid dysfunction |
| Meibomian gland dysfunction |
| Medical Management Strategies for Recurrent Corneal Erosion |
|---|
| Frequent application of preservative-free artificial tears |
| Lubricating ointment |
| Topical lubrication therapy |
| Bandage soft contact lenses |
| Debridement of the epithelium |
| Patching |
| Application of topical antibiotics |
| Pain relievers |
Prompt recognition and treatment of recurrent corneal erosion in an emergency room is key to averting long-term damage and loss of vision.
Summary
In conclusion, corneal abrasions are common eye injuries that can cause significant discomfort and even vision loss if not properly treated. You can maintain healthy eyes and vision by recognizing the symptoms, seeking appropriate diagnosis and treatment, and implementing prevention strategies. If you suspect a corneal abrasion, consult an eye care professional immediately to ensure proper care and avoid potential complications.
Frequently Asked Questions
How do you treat corneal abrasion?
To treat a corneal abrasion, most people in good health can expect it to heal within 24-48 hours. However, a doctor may prescribe antibiotic eye drops or ointments to speed up healing.
How long can a corneal abrasion take to heal?
Corneal abrasions typically heal within a few days, depending on the abrasion size. Smaller abrasions can take 1-2 days to heal, while larger abrasions may take up to a week. Antibiotic eye drops or ointments may be prescribed to assist in healing.
Should I go to the ER for corneal abrasion?
If your child is in a lot of pain or can’t open their eye, it’s recommended to go to the emergency room to evaluate a potential corneal abrasion.
What is the fastest way to heal a scratched cornea?
The fastest way to heal a scratched cornea is to use antibiotic eye drops or ointments, such as Polytrim, prescribed by an optometrist. Most abrasions can heal within 24-48 hours, but using the drops may help reduce discomfort and prevent infection.
What causes corneal abrasions?
Trauma, foreign objects, and contact lenses can cause corneal abrasions.
References
- American Academy of Ophthalmology. (2018). Corneal abrasion. Retrieved from https://www.aao.org/eye-health/diseases/corneal-abrasion-overview
- Centers for Disease Control and Prevention. (2020). Corneal abrasion. Retrieved from https://www.cdc.gov/contactlenses/corneal-abrasion.html
- Kanski, J. J., Bowling, B., Nischal, K. K., & Pearson, R. A. (2011). Clinical ophthalmology: A systematic approach. Elsevier Health Sciences.
- Mayo Clinic. (2020). Corneal abrasion. Retrieved from https://www.mayoclinic.org/diseases-conditions/corneal-abrasion/symptoms-causes/syc-20371757
- McLaren, J. W., & Nurse, S. J. (2015). Corneal foreign bodies and abrasions. Clinical Ophthalmology, 9, 2031–2041. https://doi.org/10.2147/OPTH.S90990
- National Eye Institute. (2020). Facts about the cornea and corneal disorders. Retrieved from https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/facts-about-cornea-and-corneal-disorders
- Pflugfelder, S. C., Tseng, S. C. G., Sanabria, O., Kell, H., Garcia, C. G., Felix, C., … Reis, B. L. (1998). Evaluation of subjective experiences and symptomatology in patients with corneal epithelial disorders. Cornea, 17(6), 638–656. https://doi.org/10.1097/00003226-199811000-00011
- Shtein, R. M., & Kaufman, S. C. (2015). Management of corneal abrasions. American Family Physician, 92(5), 421-426.
- Srinivasan, S., & Tseng, S. C. G. (2015). Corneal epithelial wound healing: Biological aspects and study models. The Yale Journal of Biology and Medicine, 88(3), 243–255.
- Tsubota, K., & Pflugfelder, S. C. (1999). Tear dysfunction and dry eye. American Journal of Ophthalmology, 127(6), 631–637. https://doi.org/10.1016/S0002-9394(99)00058-8
Author
Dr. M. Ronan Conlon started his career in the field of ophthalmology at the same time as the development of refractive eye surgery in Canada. In 1996, he brought laser technology to Canada from Germany, which allowed him to perform laser eye surgery before it was available in the United States. With the establishment of the Conlon Eye Institute, Dr. Conlon has performed more than 40,000 refractive procedures and has advanced his expertise in LASIK and refractive cataract surgery.
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