Corneal abrasion

What is a corneal abrasion?

The cornea is the transparent layer at the front of the eye. A corneal abrasion is a scratch on the cornea.

What symptoms does a corneal abrasion cause?

The cornea contains many nerves. This means that a scratch will be very painful. Corneal abrasions can also cause sensitivity to light, redness of the eye and blurred vision. You may also experience eyelid swelling and a lot of watering of the eye.

What causes a corneal abrasion?

Injuries from fingernails, hairbrushes, tree branches and paper are common causes. Grit or other tiny foreign bodies under the eyelid can scratch the cornea as well.

What treatment is available?

Abrasions usually heal by themselves. However, the nurse or doctor will usually prescribe antibiotic drops or ointment for a few days. These are given to reduce the chances of infection in the cornea whilst the abrasion is healing.

You may use over-the-counter lubricants if you find these soothe your eyes. However, your natural tears are usually adequate for helping the corneal abrasion heal.

The nurse or doctor may prescribe dilating drops or administer this when they examine you. This may help the pain. It will cause your pupil to be dilated for up to a day after they are used and result in temporarily blurred vision. You should not drive if your eye has been dilated.

During your examination, the nurse or doctor may put an anaesthetic drop in your eye(s). This provides temporary relief of pain for about half an hour. However, anaesthetic drops must not be used apart from during the examination of your eye in the hospital. They can cause permanent damage to the eye and vision if used more frequently.

You may use over-the-counter painkillers. However, most patients find that the pain is still quite severe for the first two days. Wearing sunglasses may help reduce light sensitivity.

What follow-up is required?

Most patients do not need a further appointment. However, if after 48 hours the pain in your eye has not started to improve or if the vision or pain worsens significantly you should call the Eye Emergency Clinic on the number below during working hours, Monday to Friday. At weekends you may attend the Emergency Department during the day. The pain and visual disturbance usually resolve in three to four days. There may be a slight gritty discomfort for a further few days.

You may be given a follow-up appointment in the Eye Emergency Clinic if you are a contact lens wearer or if there is concern about more extensive injury to your eye.

Contact lenses

If you have recently worn contact lenses, the nurse or doctor who sees you may advise review in the Ophthalmology Department. This is because contact lenses can sometimes cause infection of the cornea. You should not use contact lenses again until one week after the corneal abrasion has healed. You should see the optician who provides your contact lenses before you start using them again.

Recurrent corneal erosion syndrome

A small number of patients who experience a corneal abrasion may experience further episodes of pain. This may be because the cornea has not healed completely; this is known as corneal erosion.

• A small area of the skin of the cornea may be more weakly attached than normal. This area may become loose during sleep.
• You may experience pain in the eye on waking. This can occur months or years after the injury that caused the corneal abrasion.

You should consult an optician if you experience these episodes. You can also attend the Emergency Department if the pain is severe. Night-time lubricating eye ointment may help to treat this condition.

Contacts/ Further information

Eye emergency clinic: 01223 217778. Monday to Friday 08:30-16:30. Leave a message, including your contact details, and a nurse will phone you back. Outside of this time, attend the Emergency Department.