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Corneal abrasions or scratches account for about 1.57 percent of eye injuries each year. The cornea is a layer of the eye that is transparent and thin. It covers the pupil and iris. You may think of a corneal scratch as an 'eyeball' scratch.
When a scratch occurs on the cornea, pain and other symptoms can cause varying degrees of discomfort. (Learn More)
When a scratch is minor, it is referred to as an abrasion. Scratches have different degrees of severity that can affect this structure of the eye. In some cases, a scratched cornea can lead to further problems, such as iritis or a corneal ulcer. (Learn More)
The first step in treating the scratch is administering first aid to protect the scratched cornea. (Learn More) Then, go to the doctor to have them fully evaluate the scratch. From there, the doctor will determine which treatment options are necessary.
Once doctors prescribe treatment, they usually follow up with patients in about 24 hours. (Learn More) During this visit, they will see if the scratch is healing and be able to detect any possible complications.
The symptoms may occur immediately after the scratch occurs or several hours later. The symptoms vary and can be mild to severe. They include the following:
- Feeling like there is a foreign object in the eye
- Blurry vision
- Vision loss
- Light sensitivity
It may be hard to keep the affected eye open. However, moving the eyelid to close and open the eye may intensify the pain.
If anything gets into or touches the eye, it is possible for the cornea to get scratched. There are times when the exact cause cannot be identified.
The following are possible causes of a scratched cornea:
- Something blows into or hits your eye, such as ash or other airborne debris
- Sports injuries
- Contact lenses that do not fit right or are not properly maintained
- Vigorous rubbing the eyes
- Having surgery that uses general anesthesia
- Foreign matter under the eyelid that gets stuck
- Getting poked in the eye
- Bacterial infection, trachoma, or other eye conditions
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
- Iris displacement
The first step in treatment is getting an accurate diagnosis. The doctor will use a yellow dye and put it on the eye’s surface. It will collect in the scratch and light up green. This is when the doctor uses a cobalt blue light. This shows if there is a corneal scratch present.
There are several treatments that doctors might prescribe to treat a scratched cornea. These can also help to protect the eye to reduce the risk of complications.
- First aid: It is important to get medical attention right away if a scratched cornea occurs. While waiting for medical attention, the following first aid steps can be beneficial:
- Use a saline solution or clean water to rinse the affected eye.
- Pull the upper eyelid over the lower to induce tearing.
- Blink multiple times to dislodge small particles.
Never rub or touch the affected eye. Do not put contacts in.
- Topical NSAIDs: These medicines are used to alleviate inflammation and pain that occurs with a scratched cornea. Commonly prescribed medicines include ketorolac and diclofenac. 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.
- Topical antibiotics: If an infection sets in, this can delay the healing time of a scratched cornea. Because of this, some doctors will prescribe topical antibiotics as a type of prophylactic treatment. One study showed that using this method may reduce the risk of a corneal ulcer. However, using prophylactic antibiotics does not seem to increase healing time.
- Mydriatics: This treatment is not often used for corneal abrasions anymore. At one time, doctors prescribed these medicines to alleviate ciliary muscle spasms. The belief was that these spasms happen with scratched corneas, and alleviating them would reduce pain. One study concluded that an eye lubricant was just as effective for reducing pain.
- Eye patching: This is not commonly used anymore. Some doctors may still prescribe this method, but research shows that it may actually increase pain. One study revealed that using an eye patch for a scratched cornea increased pain in 48 percent of people.
- Oral analgesics: In some cases, doctors might prescribe an oral pain medicine to reduce discomfort. This is usually an over-the-counter medicine, such as ibuprofen.
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.
Preventing Future Scratches
It is not always possible to prevent corneal scratches, but there are some safety measures people can take to reduce their risk. When airborne debris is present, always wear protective goggles to prevent the debris from getting into the eyes.
People who wear contacts should not wear them past the prescribed date. It is also imperative to use the right solution for contact lenses.
If dry eyes played a role in the scratched cornea, following the regimen to alleviate this issue is important. A doctor should evaluate the person’s eye dryness and prescribe the proper treatments.
If you believe that you scratched your cornea, it is imperative to seek prompt medical treatment. The risks involved can be serious if you leave the issue untreated.
There are viable treatment options that can help you restore the health of your eyes.
Corneal Abrasion. (January 3, 2019). Medscape.
Corneal Abrasion Symptoms. (July 3, 2012). American Academy of Ophthalmology.
What Causes a Corneal Abrasion? (July 3, 2012). American Academy of Ophthalmology.
Corneal Ulcer. Merck Manual.
Corneal Abrasion: How to Treat a Scratched Eye. All About Vision.
Corneal Abrasion (Scratch): First Aid. Mayo Clinic.
Should We Patch Corneal Abrasions? (March 1997). Archives 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.
Ocular Trauma and Antibiotic Prophylaxis for the Prevention of Corneal Ulceration. (April 2001). British Journal of Ophthalmology.