A scratched cornea can be very painful if the scratch is severe. Even minor scratches generally involve some degree of discomfort.

The most common signs of a scratched cornea are pain, tearing, redness, headache, light sensitivity, and feeling like something is stuck in your eye.

Most often, a scratched cornea occurs because something pokes the eye or gets caught under the eyelid.

A scratched cornea or corneal abrasion is generally treated with medicated eye drops, such as antibiotics. You may need to wear a patch over the affected eye for a period of time.

Depending on the severity of the scratch, the recovery timeline will vary. Your eye doctor will give you an overall idea of your specific recovery timeline.

While you can’t completely prevent corneal abrasions, there are some steps you can take to decrease the likelihood that they will occur.

Symptoms

With a scratched cornea, symptoms can vary according to the severity of the scratch. Some issues may occur right away, whereas others may take a few hours to appear.

Symptoms include the following:

  • Feeling like there is something in your eye
  • Sensitivity to light
  • Blurriness
  • Pain or discomfort
  • Redness
  • Watery eyes
  • Some loss of vision
  • Headache

The symptoms may cause you to want to rub or press on your eye. Avoid this, as it can cause further damage.

Causes of Scratched Corneas

man and daughter holding kite

Virtually anything that can poke your eye can cause a scratched cornea. A spec of dirt or dust that gets trapped underneath your eyelid can result in a corneal abrasion.

You might get a scratched cornea if you:

  • Rub your eyes vigorously.
  • Get sand or dirt in your eye.
  • Poke your eye with a pen, a makeup brush, your fingernail, or any other objects.
  • Wear expired contact lenses.
  • Get some types of chemicals in your eye.
  • Engage in contact sports or construction activities without eye protection.
  • Get some types of infections in the eye.

Run into a tree branch that pokes your eye.

How Common Are Scratched Corneas?

Scratched corneas are common. In fact, they are one of the most common types of eye injuries.

Overall, corneal abrasions or scratches make up 10 percent of emergency eye care.

Risks of a Scratched Cornea

If a scratched cornea is not treated, there is the risk for developing corneal ulcers. This condition is an open sore located on the cornea that results from an infection.

There are many possible complications that can occur with a corneal ulcer.

  • A vision-impairing cloudy scar, which may happen even with treatment
  • Perforation of the cornea
  • Eye socket tissue destruction
  • Deep-seated infection

Scratches vs. Abrasions

A scratch and an abrasion are essentially the same thing. Sometimes, minor scratches are more commonly referred to as abrasions, but any type of scratch on the cornea can be called an abrasion.

Deep scratches may be referred to as corneal lacerations. This type of deep scratch generally cuts partially or fully through the cornea.

How to Treat a Scratched Cornea

old man with vision problems

If you suspect you have a scratched cornea, it is important to see a doctor as soon as possible.

An eye doctor will put a yellow dye on the surface of your eye. The dye will collect in the scratch and light up green. The doctor will then shine a cobalt blue light on the area to determine if a corneal abrasion is present.

The eye doctor will recommend specific treatments, depending on the severity of the scratch. Here are some treatments that are commonly used:

  • Immediate care: If you feel you have something in your eye, or you think you have a scratched cornea, there are immediate steps to take.
    • Repeatedly blink to dislodge any small particles, like dust or dirt, that may be in the eye.
    • Pull the upper eyelid out and over the lower eyelid. This can induce tearing, helping to flush any particles from the eye
    • Blink repeatedly to dislodge small particles.
    • Do not attempt to touch or rub your eye to remove particles. This can cause further abrasions.
  • Topical antibiotics: Infection can be a major issue with scratched corneas, as it delays healing and worsens the issue. Your eye doctor may prescribe topical antibiotics to prevent infection. While the use of prophylactic antibiotics does not seem to speed the healing process, one study demonstrated that they may lower the overall risk of a corneal ulcer. This is an open sore on the cornea that can lead to various issues, such as:
    • A vision-impairing cloudy scar.
    • A puncture in the cornea.
    • Serious infection.
    • Damage to eye socket tissue.
    • Displacement of the iris.
  • Topical NSAIDs: Your doctor may prescribe these medications to reduce inflammation and lessen pain. Ketorolac and diclofenac are commonly prescribed for scratched corneas. One study showed that using these medicines provided excellent pain relief and helped to alleviate other symptoms. The same study determined that when people use topical NSAIDs, they return to work earlier, take fewer oral analgesics, and need fewer narcotics overall.
  • Eye lubricants: Eye lubricants are often recommended to alleviate pain from a scratched cornea.
  • Eye patching: While this method used to be commonly prescribed, it is not commonly used anymore. Research shows that eye patching may actually increase pain. One study found that using an eye patch for a scratched cornea increased pain in 48 percent of people.
  • Oral pain medication: Most often, over-the-counter pain medications are recommended to reduce pain associated with scratched corneas. In some instances, doctors may prescribe pain medications for severe cases.

ibuprofen

How Long Does the Cornea Take to Heal?

The time to recover depends on the severity of the scratch or abrasion.

On average, a minor abrasion heals within 24 to 48 hours. It may take a week for scratches that are deep or extensive.

These timelines are for scratches that are under the treatment of a doctor. Healing may take longer or not occur at all if someone does not seek medical treatment for a scratched cornea.

How to Prevent Scratches on the Eye

It is not possible to prevent every corneal abrasion, but you can take certain steps to reduce the likelihood of getting one.

  • Wear protective eye goggles when airborne debris is present.
  • Do not wear expired contact lenses.
  • Use an appropriate saline solution for your contact lenses.
  • Alleviate dry eyes by using recommended lubricating solutions.
  • Wear protective eyewear if participating in contact sports or doing any kind of activity where debris could fly into your eyes.
  • Do not vigorously rub your eyes.
  • Use makeup brushes carefully around your eyes.

Keep your fingernails trimmed and avoid touching your eyes directly.

References

Corneal Abrasion. (January 2019). Harvard Medical School.

Corneal Abrasion. Encyclopedia of Children’s Health.

Corneal Abrasion and Erosion. (September 2020). American Academy of Ophthalmology.

Corneal Abrasions. (September 2015). KidsHealth from Nemours.

What Is a Corneal Laceration? (September 2019). American Academy of Ophthalmology.

Corneal Ulcer. Merck Manual.

Corneal Abrasion Symptoms. (July 2012). American Academy of Ophthalmology.

What Causes a Corneal Abrasion? (July 2012). American Academy of Ophthalmology.

Mydriatics in Corneal Abrasion. (July 2001). Emergency Medicine Journal.

Update: Do Ophthalmic Nonsteroidal Anti-Inflammatory Drugs Reduce Pain Associated with Simple Corneal Abrasion Without Delaying Healing? (January 2003). Annals of Emergency Medicine.

Should We Patch Corneal Abrasions? (March 1997). Archives of Ophthalmology.

Ocular Trauma and Antibiotic Prophylaxis for the Prevention of Corneal Ulceration. (April 2001). British Journal of Ophthalmology.

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