Corneal Injury

Overview, Causes, & Risk Factors

The cornea is the clear window on the front of the eye that coversthe colored iris and pupil. The two most common types of corneal injuries areabrasions and lacerations. An abrasion is a scraping of the surface of thecornea. A corneal laceration involves a scratch or a puncture through thelayers 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:

  • chemicals that are splashed into the eye
  • contact lenses that are left in place too long
  • eye disorders, including glaucoma and conjunctivitis
  • foreign bodies, suchas tree branches and mascara wands
  • foreign bodies that are stuck under an eyelid
  • medical conditions that prevent the person from closing his or hereyelids
  • sand, sawdust, or other material that is blown into the eye
  • Symptoms & Signs

    What are the signs and symptoms of the injury?

    The symptoms of a corneal injury may include:

  • bleeding from the surface blood vessels of the eye
  • blurred vision
  • a feeling that there is something in the eye
  • pain, which can be severe
  • redness
  • sensitivity to light
  • swelling of the eye
  • tearing from the eye
  • Diagnosis & Tests

    How is the injury recognized?

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

    Prevention & Expectations

    What can be done to prevent the injury?

    It’s important to wear contact lenses as instructed. Prompttreatment of eye disorders may prevent some corneal injuries. Safety glassesshould be worn in all situations where matter might enter the eye. Theseinclude:

  • grinding
  • mowing the lawn
  • welding
  • working under a car
  • working with sheet metal or wood
  • Treatment & Monitoring

    What are the treatments for the injury?

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

  • a garden hose at a very low flow
  • a glass or other container full of water
  • a shower
  • a sink
  • a water fountain
  • The eyelids must be held apart so that all parts of the eye are washed. Thiswashing must be done within minutes of the injury. The corner of a facialtissue or the tip of a cotton applicator may be used to remove any remainingsmall debris. The bottom of a paper cup can be taped over the eye to protect itfrom further injury.

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

    A healthcare providershould always examine chemical burns to the eye. The burns can be severe anddamage the eye in a short period of time. These types of injuries can result incomplications, even years after the initial injury. In cases of scratches andchemical 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 tosleep with medicine.

    Corneal abrasions and lacerations can be quite painful, and theyincrease the person’s risk for infection. Pain medicines and tetanus booster shots may be ordered by the healthcareprovider.

    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 nolong-term effects from the injury. Severe injuries, however, may causepermanent visual impairments.

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

    Article type: xmedgeneral