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Corneal injury

Abrasion - corneal; Scratch - corneal; Eye pain - corneal

Corneal injury is a wound to the part of the eye known as the cornea. The cornea is the crystal clear (transparent) tissue that covers the front of the eye. It works with the lens of the eye to focus images on the retina.

Causes

Injuries to the cornea are common.

Injuries to the outer surface may be due to:

  • Abrasions: Includes scratches or scrapes on the surface of the cornea
  • Chemical injuries: Caused by almost any fluid that gets into the eye
  • Contact lens problems: Overuse, poor fit, or sensitivity to contact lens care solutions
  • Foreign bodies: Exposure to something in the eye such as sand or dust
  • Ultraviolet injuries: Caused by 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
  • Use a hammer or power tools without wearing safety glasses

High-speed particles, such as chips from hammering metal on metal, may get stuck in the surface of the cornea. Rarely, they may penetrate deeper into the eye.

 

Symptoms

Symptoms include:

Exams and Tests

You will need to have a complete eye test. The health care provider may use eye drops called fluorescein dye to help look for injuries.

Tests may include:

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 seen in an emergency care center or examined by an ophthalmologist right away.

Treatment for corneal injuries may involve:

  • Removing 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)

Most of the time, injuries that affect only the surface of the cornea 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 is not better after 2 days of treatment.

Prevention

Things you can do to prevent corneal injuries include:

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

References

Guluma K, Lee JE. Ophthalmology. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 61.

Knoop KJ, Dennis WR. Ophthalmologic procedures. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 62.

Rao NK, Goldstein MH. Acid and alkali burns. In: Yanoff M, Duker JS, eds. Ophthalmology. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 4.26.

Yanoff M, Cameron JD. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 423.

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    • Cornea

      Cornea - illustration

      The cornea is the crystal clear portion of the surface of the eye that lets light enter. The cornea is well supplied with nerve endings which is why some people can never get used to wearing contacts.

      Cornea

      illustration

      • Cornea

        Cornea - illustration

        The cornea is the crystal clear portion of the surface of the eye that lets light enter. The cornea is well supplied with nerve endings which is why some people can never get used to wearing contacts.

        Cornea

        illustration

       

      Review Date: 8/28/2018

      Reviewed By: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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