A corneal abrasion is a scratch on the surface epithelium of the cornea. An abrasion, or foreign body in the eye, is the most common eye injury. With treatment, the prognosis is usually good.
A corneal abrasion usually results from a foreign body, such as a cinder or a piece of dust, dirt, or grit that becomes embedded under the eyelid. Even if the foreign body is washed out by tears, it may still injure the cornea. Small pieces of metal that get in the eyes of workers who don’t wear protective glasses quickly form a rust ring on the cornea and cause corneal abrasion. Such abrasions also commonly occur in the eyes of people who fall asleep wearing hard contact lenses or whose lenses aren’t fitted properly.
A corneal scratch produced by a fingernail, a piece of paper, or other organic substance may cause a persistent lesion. The epithelium doesn’t always heal properly, and a recurrent corneal erosion may develop, with delayed effects more severe than the original injury.
In the United States, corneal abrasions are a common ophthalmologic cause of emergency department visits. Incidence is highest among younger, physically active individuals; corneal abrasions are rare in elderly people.
A corneal abrasion typically produces redness, increased tearing, discomfort with blinking, a sensation of “something in the eye” and, because the cornea is richly endowed with nerve endings from the trigeminal nerve (cranial nerve V), pain disproportionate to the size of the injury. It may also affect visual acuity, depending on the size and location of the injury.
History of eye trauma or prolonged wearing of contact lenses and typical symptoms suggest corneal abrasion.
Examining the eye with a flashlight may reveal a foreign body on the cornea; the eyelid must be everted to check for a foreign body embedded under the lid.
Before beginning treatment, a test to determine visual acuity provides a medical baseline and a legal safeguard.
Topical anesthetic eyedrops are instilled in the affected eye before removal of a superficial foreign body, using a foreign body spud. A rust ring on the cornea must be removed with an ophthalmic burr. When only partial removal is possible, reepithelialization lifts the ring again to the surface and allows complete removal the following day.
Treatment also includes instillation of broad-spectrum antibiotic eyedrops in the affected eye every 3 to 4 hours. Application of a pressure patch prevents further corneal irritation when the patient blinks. If the patient wears contact lenses, it may be advisable for him to abstain from wearing the lenses until the corneal abrasion heals.
❑ Assist with examination of the eye. Check visual acuity before beginning treatment.
❑ If a foreign body is visible, carefully irrigate with normal saline solution.
❑ Tell the patient with an eye patch to leave it in place for 6 to 12 hours. Warn that a patch alters depth perception, so advise caution in daily activities, such as climbing stairs or stepping off a curb.
❑ Reassure the patient that the corneal epithelium usually heals in 24 to 48 hours.
❑ Stress the importance of instilling antibiotic eyedrops, as ordered, because an untreated corneal abrasion, if infected, can lead to a corneal ulcer and permanent vision loss. Teach the patient the proper way to instill eye medications.
❑ Emphasize the importance of safety glasses to protect workers’ eyes from flying fragments. Also review instructions for wearing and caring for contact lenses, to prevent further trauma.
Review other book chapters online related to Corneal ulcer:
Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
What do you think about the features of this website?
Take our user survey and have your say:
Next articles: Tools & Services:
Medical Articles:
Treatment
Special considerations
Book Source Details
More About Corneal ulcer
More Medical Textbooks Online about Corneal ulcer
Medical Books Excerpts
More About This Book:
Title: Professional Guide to Diseases (Eighth Edition)
Authors: Springhouse
Publisher: Lippincott Williams & Wilkins
Copyright: 2005
ISBN: 1-58255-370-X
» Next page: Corneal ulcers (Handbook of Diseases)
Rate This Website
Medical Tools & Articles:
Forums & Message Boards
Search Specialists by State and City
By using this site you agree to our Terms of Use. Information provided on this site is for informational purposes only; it is not intended as a substitute for advice from your own medical team. The information on this site is not to be used for diagnosing or treating any health concerns you may have - please contact your physician or health care professional for all your medical needs. Please see our Terms of Use.
Copyright © 2009 Health Grades Inc. All rights reserved.
