Corneal Laceration: What Is It & How to Treat

A corneal laceration is cut that is located on the cornea, or the transparent part of the eye that covers the pupil and the iris. 

A laceration to the cornea is most commonly caused by an external injury, such as a sharp object coming into contact with the eye. When such an object hits the cornea with sufficient force, a cut can occur. 

There is a distinction between a corneal abrasion and a corneal laceration, with the latter being a deeper (partial or full) cut to the cornea. A laceration is more severe, and it typically requires surgery. 

What to Do if Your Eye Is Injured

A corneal abrasion typically heals on its own within 24 to 48 hours. However, a more severe laceration warrants medical attention. 

The first step to take if you have suffered an injury to your eye is to protect it. If you experience an injury to your eye that causes pain or discomfort and you believe might be a laceration, the American Academy of Ophthalmology recommends taking the following steps:

• Immediately shield the eye to prevent further damage. You can do so by cutting out the bottom section of a paper cup and taping this over the eye. Do not apply any pressure directly to the eye.
• Avoid rinsing with water. Some organizations recommend rinsing the eye with water or a saline solution when an abrasion occurs, but for severe lacerations, this can increase the risk of contaminants entering the eye and causing an infection.
• Do not attempt to remove any objects that remain in the eye that have caused the laceration.
• Avoid rubbing or placing pressure on the eye.
• Do not take any non-steroidal anti-inflammatory drugs, such as ibuprofen or aspirin. These blood-thinning drugs can increase bleeding.
• Seek medical attention once you have protected the eye using these guidelines. 

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Symptoms of Corneal Laceration

Symptoms of a corneal laceration may include any or all of the following:

• Pain, which can range from moderate to severe, depending on the nature of the cut
• Secretion of tears
• Decreased vision or blurring of vision
• Bleeding within the eye. 
• Heightened sensitivity to light
• Feeling that something is stuck in the eye

Causes

The most common cause of a corneal laceration is injury caused by an external object entering the eye and penetrating the surface of the cornea. Some of the most common activities in which corneal lacerations occur include the following:

• Woodworking
• Machining and metal cutting
• Stone carving
• Glass cutting

Coming into contact with sand, dirt, or dust in the air can induce a corneal laceration if the force is sufficient and the impact occurs directly to the surface of the cornea. 

Living in a climate in which there is heavy wind can increase the risk of foreign objects entering the eye and causing a laceration. In such environments, it is advisable to wear glasses or an alternative form of protective eyewear at all times when outdoors. 

Risk Factors

Individuals who work in the following professions face a higher risk of suffering a laceration to the cornea than the average person:

• Builders
• Woodworkers 
• Gardeners
• Metal workers
• Builders
• Miners
• Car manufacturers 
• Landscapers 

If you are involved in any of the above activities, it is essential that you wear protective eyewear. 

Still, anyone walking down the street is also at risk for a corneal laceration. While you can take extra precautions by being aware of your surroundings and wearing sunglasses outdoors, you can’t mitigate all risks.

Diagnosis of a Corneal Laceration

Once you have protected your eye, seek medical attention from an ophthalmologist. They will perform a comprehensive eye examination to determine the magnitude of the injury and whether or not you have suffered a corneal laceration. 

While the doctor will assess your vision, overall eye structure, and eye movement during this exam, the primary diagnosis of a corneal laceration is done via the slit-lamp portion of the exam. The doctor will use a slit-lamp biomicroscope to view the laceration since it won’t be visible without this tool.

The doctor may also use a special dye to highlight the abrasion. Fluorescein dye drops are put in the eye, and a blue light is shined into the eye. If there is a laceration or abrasion, it will appear green under the light.

Treatment for a Corneal Laceration

A corneal laceration is an urgent matter that requires immediate medical attention. If it is severe and left untreated, vision loss can occur. 

The type of treatment you receive will primarily depend on the severity of the laceration.

If the laceration is minor, no treatment may be needed. These mild lacerations will usually heal on their own within one to two days. Antibiotic eye drops may be prescribed to prevent infection and aid healing.

Cases of moderate to severe corneal lacerations may require surgery, which is done to close the cut and prevent infection. Surgery may also be necessary for preventing subsequent damage to the eye and to remove foreign objects that remain in the eye following the injury. 

In cases of severe laceration, multiple surgeries may be required in order to fully repair the eye. You may also receive medication to alleviate pain. 

You may also be at risk of glaucoma, infection, a detached retina, and even vision loss if you have experienced a corneal laceration. You’ll remain under the care of your ophthalmologist following surgery to ensure it heals correctly.

How to Prevent a Corneal Laceration: Best Practices

The two most effective ways to prevent a corneal laceration are to wear protective eyewear and to avoid performing activities that pose a high risk of injury to the eye. 

If a foreign object enters your eye, avoid rubbing it. This will help ensure it does not penetrate the surface of the cornea. Seek medical attention immediately. 

If you know that you are going to be involved in any of the aforementioned activities or in conditions where there will be heavy wind, wear high-quality, protective eyewear. Wearing glasses regularly can also help to protect your eyes from foreign objects entering and penetrating the cornea.

While you can’t prevent every accident, being cautious and protecting your eyes can reduce the likelihood of a corneal laceration.

References

1. What Is a Corneal Laceration? (October 2022). American Academy of Ophthalmology.

2. Corneal Injuries: Lacerations and Abrasions. (February 2019). Ophthalmology Center Barcelona.

3. Eye Exam and Vision Testing Basics. (March 2018). American Academy of Ophthalmology.

4. Fluorescein. (July 2022). StatPearls.

5. Evaluation and Management of Ocular Traumas. (January 2022). Vision Correction and Eye Surgery.

6. Management of Corneal Lacerations and Perforations. (Fall 2013). International Ophthalmology Clinics.