“Please fix my corneal abrasion”
“I have a corneal abrasion and it is really painful, what can I do?”
Corneal abrasions can result from
- foreign material blowing on to the surface of the eye or under the eyelid
- contact lenses
- severe dry eye
These are termed “minor injuries” and yet can cause exquisite eye pain because the cornea has so many fine nerves in it that an abrasion is extremely painful.
Corneal abrasion cause
- sensitivity to light
- foreign body sensation
- a gritty feeling
Often the symptoms are made worse by light, your eye feels awful each time you blink and can get worse after you rub the eye. Examination by an urgent eye care ophthalmologist will confirm, after putting in a Fluorescein-dye eye drop and using a blue light at the slit lamp, where the corneal abrasion is and its size.
If you have a corneal abrasion, it will most likely recover spontaneously in 24 to 48 hours and very few progress to an infection of the cornea. However, since they can be very painful and in order to establish the diagnosis and get immediate treatment, you can see the urgent eye care ophthalmologist, for instance here at Clinica London.
Treatment for corneal abrasion
The treatment for corneal abrasion includes the following:
- If there is a foreign body blown into the eye, immediately wash it out with tap water or saline.
- However, if you have a corneal foreign body or a subtarsal foreign body (underneath the eyelid), this will have to be removed by the ophthalmologist.
- Use over-the-counter antibiotics by drops or ointment or from your ophthalmologist.
- Pad the eye. Eye padding is controversial. It used to be that ophthalmologists treated corneal abrasions with eye padding, along with dilating drops and antibiotics, but several studies have shown that it does not necessarily speed up recovery. However, an eye pad can soothe and comfort the patient, particularly if used with eye ointment and a Cycloplegic drop, which stops the painful ciliary spasm associated with a corneal abrasion.
- Dilating the pupil with a Cycloplegic eye drop. Dilating the pupil can help to reduce the pain of a corneal abrasion. The urgent eye care ophthalmologist will use a drop such as Cyclopentolate to dilate the pupil in the first 24-hours and help to relax the ciliary spasm, which is causing the pain and headache.
- Topical anaesthetic. Topical anaesthetic drops are not recommended for corneal abrasion apart from allowing the urgent eye care ophthalmologist to examine your eye and the cornea accurately. Patients should not use topical anaesthetic drops outside the ophthalmologist’s examination room. If you instil anaesthetic eyedrops at home, there is a real risk that the eye will suffer a further corneal abrasion if something should blow into it, or if you should rub the eye when anaesthetised. You could exacerbate the existing corneal abrasion and delay its healing with use of anaesthetic eye drops. AVOID!
- Bandage contact lens. Occasionally the ophthalmologist will put on what is called a bandage contact lens, which can help to reduce the pain by stopping the contact between the eyelid and the corneal epithelium and can sometimes help the corneal abrasion to heal underneath. It is only used occasionally in selected cases.
- Analgesia and a good night’s sleep. Once you have seen your ophthalmologist and they have established that you have a corneal abrasion they may well have given you an eye pad, or they may not have. They will ask you to rest as much as possible in the first 24-hours and to take some oral analgesia and get a good night’s sleep.
Treatment for corneal abrasion
The treatment for your corneal abrasion may be nothing, eye patching, dilating the pupil with Cycloplegic mydriatic, topical antibiotic drops or ointment, oral analgesia and, finally, follow-up.
Follow-up after Corneal Abrasion
If you had a corneal abrasion and you have seen your ophthalmologist, he or she will want to follow you up to make sure that the abrasion has fully healed. This will usually be after 24 to 48 hours and once again three or four days later. If you are a contact-lens wearer, you should not wear your contact lenses.
If you are immunocompromised or only have one eye (monocular), then your ophthalmologists will want to monitor your eye more closely.
Deeper corneal injury
Fortunately, most minor injuries only cause a corneal abrasion. Occasionally the wound from a sharp object is much deeper and can penetrate into the eye, causing a deep eye injury.
A referral to an ophthalmologist is required, particularly if there is a deep eye injury, if the patient cannot remove the foreign body, or if the corneal abrasion appears to be recurring – called a recurrent corneal erosion (RCE) – or if your symptoms persist after two to three days or if they are getting worse.
Fortunately, most corneal abrasions are preventable with appropriate eyewear for high-risk occupations and sports. Eye protection can include plastic safety glasses, helmets and helmets with facemasks.
Corneal abrasion is the most common minor eye injury. Here at Clinica London, we see many patients with minor corneal abrasions and corneal foreign bodies or subtarsal conjunctival foreign bodies causing corneal abrasion. We are available every day to advise you if you think that you require treatment for a corneal abrasion.