Corneal injury

Causes

Injuries to the cornea are common.

Injuries to the outer surface of the cornea, called corneal abrasions, may be caused by:

• Chemical irritation - from almost any fluid that gets into the eye
• Overuse of contact lenses or lenses that don't fit correctly
• Reaction or sensitivity to contact lens solutions and cosmetics
• Scratches or scrapes on the surface of the cornea (called an abrasion)
• Something getting into the eye (such as sand or dust)
• Sunlight, sun lamps, snow or water reflections, or arc-welding

Infections may also damage the cornea.

You are more likely to develop a corneal injury if you:

• Are exposed to sunlight or artificial ultraviolet light for long periods of time
• Have ill-fitting contact lenses or overuse your contact lenses
• Have very dry eyes
• Work in a dusty environment

High-speed particles, such as chips from hammering metal on metal, may become embedded in the surface of the cornea. Rarely, they may pass through the cornea and go deeper into the eye.

Watch this video about:Corneal injury

Symptoms

• Blurred vision
• Eye pain or stinging and burning in the eye
• Feeling like something is in your eye (may be caused by a scratch or something in your eye)
• Light sensitivity
• Redness of the eye
• Swollen eyelids
• Watery eyes or increased tearing

Exams and Tests

A complete eye exam must be done. The health care provider may use a special drop called fluorescein dye that helps identify corneal injuries.

Tests that are used to examine the eye for damage to the cornea include:

• Standard ophthalmic exam
• Slit lamp examination 

Treatment

First aid for eye emergencies:

• DO NOT try to remove an object that is stuck in your eye without professional medical help.
• If chemicals are splashed in the eye, IMMEDIATELY flush the eye with water for 15 minutes. The person should be quickly taken to the nearest emergency room.

Anyone with severe eye pain needs to be evaluated in an emergency care center or by an ophthalmologist immediately.

Treatment for corneal injuries may involve:

• Removing any foreign material from the eye
• Wearing an eye patch or temporary bandage contact lens
• Using eye drops or ointments prescribed by the doctor
• Not wearing contact lenses until the eye has healed
• Taking pain medicines

Outlook (Prognosis)

Injuries that affect only the surface of the cornea normally heal very quickly with treatment. The eye should be back to normal within 2 days.

Injuries that penetrate the cornea are much more serious. The outcome depends on the specific injury.

When to Contact a Medical Professional

Call your health care provider if the injury has not significantly improved in 2 days with treatment.

Prevention

• Wear safety goggles at all times when using hand or power tools or chemicals, during high impact sports, or in other situations where you may get an eye injury.
• Wear sunglasses that screen ultraviolet light when you are exposed to sunlight, even during the winter.
• Be careful when using household cleaners. Many household products contain strong acids, alkalis, or other chemicals. Drain and oven cleaners are particularly dangerous. They can lead to blindness if not used correctly.

References

Yanoff M, Cameron D. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 431.

Vinger PF. The eye and sports medicine. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. On DVD-ROM. 1st ed. Philadelphia, Pa: Lippincott Williams & Wilkions;2009:chap 45.

Cameron JD. Surgical and nonsurgical trauma. In: Tasman W, Jaeger EA, eds. Foundations of Clinical Ophthalmology.  Vol. 3. Philadelphia, Pa: Lippincott Williams & Wilkions;2012:chap 6.

Sharma R, Brunette DD. Ophthalmology. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap. 69.

Update Date: 9/3/2012

Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; and Franklin W. Lusby, MD, Opthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.