Corneal Injury

The cornea is the clear window on the front of the eye that covers the colored iris and pupil. The two most common types of corneal injuries are abrasions and lacerations. An abrasion is a scraping of the surface of the cornea. A corneal laceration involves a scratch or a puncture through the layers of the cornea. Injury to the cornea can cause visual impairments.

What are the causes and risks of the injury?

The cornea can be damaged by a number of factors, including:

What are the signs and symptoms of the injury?

The symptoms of a corneal injury may include:

How is the injury recognized?

Diagnosis of a corneal injury begins with a medical history and physical exam. Many injuries cannot be seen with the naked eye. A slit lamp exam uses a microscope and a rectangular light source to examine the cornea. Often, the cornea is stained with a dye called fluorescein.

What can be done to prevent the injury?

It's important to wear contact lenses as instructed. Prompt treatment of eye disorders may prevent some corneal injuries. Safety glasses should be worn in all situations where matter might enter the eye. These include:

What are the treatments for the injury?

Treatment of corneal abrasions can begin at the site of the injury. Chemicals or small debris in the eye may be removed by rinsing the eye thoroughly with water. Some good options for rinsing the eye include:

The eyelids must be held apart so that all parts of the eye are washed. This washing must be done within minutes of the injury. The corner of a facial tissue or the tip of a cotton applicator may be used to remove any remaining small debris. The bottom of a paper cup can be taped over the eye to protect it from further injury.

Large foreign bodies or metal objects should be removed by the healthcare provider. The eye may be numbed with a local anesthetic. A cotton-tipped applicator moistened with saline or salt water may be used to remove the material. If this does not work, the object can be removed, under the microscope, with a small instrument. Once the object has been removed, antibiotic drops or ointments may be prescribed to prevent infection.

A healthcare provider should always examine chemical burns to the eye. The burns can be severe and damage the eye in a short period of time. These types of injuries can result in complications, even years after the initial injury. In cases of scratches and chemical burns, the provider will use dilating drops and antibiotics.

Corneal lacerations require immediate medical attention. Repairs are done right away, using general anesthesia. General anesthesia means the person is put to sleep with medicine.

Corneal abrasions and lacerations can be quite painful, and they increase the person's risk for infection. Pain medicines and tetanus booster shots may be ordered by the healthcare provider.

What are the side effects of the treatments?

Drops, ointments, and oral antibiotics may cause allergic reactions or irritation. Surgery may cause bleeding, infection, or allergic reaction to anesthesia.

What happens after treatment for the injury?

Most of the time, treatment is effective and the person has no long-term effects from the injury. Severe injuries, however, may cause permanent visual impairments .

Sometimes the injured area will not heal, and the person will have recurrent corneal injuries. Antibiotic drops and rewetting drops to keep the cornea wet will usually help the eye heal. Frequent rewetting of the cornea is necessary, over months, to allow this area to heal completely. Any new or worsening symptoms should be reported to the healthcare provider.

Author:William Stevens, MD
Date Written:
Editor:Crist, Gayle P., MS, BA
Edit Date:09/30/01
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:09/14/01