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Corneal Abrasion (Scratched Eye): Symptoms, Risks and Treatment

Corneal abrasions are eye injuries from a foreign object that touches your eye and scratches the cornea. Most scratches clear up in one or two days without treatment, but deeper ones need a weak to heal. These injuries rarely lead to long-term vision issues.

woman with doctor eye testing

What Are Corneal Abrasions?

Corneal abrasions are eye injuries that occur when the clear outer layer of your eye (the cornea) is hit with a foreign object. These injuries are common and are usually minor. 

Most corneal abrasions heal without medical treatment a day or two after the initial injury. Deeper abrasions may take up to a week to heal and require care from an eye doctor. Few corneal abrasions will lead to permanent eye problems. These injuries can be prevented by wearing protective eyewear in hazardous situations and taking extra care when handling objects like eye makeup brushes and contact lenses.

Symptoms

  • Eye pain
  • Eye redness
  • Feeling of grittiness, like something is stuck in your eye
  • Tearing
  • Headache
  • Sensitivity to light

Causes

A corneal abrasion is caused when a foreign object makes contact with your eye. The object often must be sharp to cause the abrasion, but this is not always true.

Your cornea (the clear outer layer of your eye) is extremely sensitive, and even light touches can be enough to scratch it. Among the objects that can cause an abrasion include:

  • Debris, such as sand, wood chips, small rocks or insects
  • Your finger or fingernails
  • Makeup brushes
  • Animal claws
  • Children’s toys
  • The edge of a piece of paper

What To Do Immediately if You Suspect a Corneal Abrasion

If you think you may have sustained a corneal abrasion, follow these three steps immediately: 

  • Rinse your eye with clean, warm water or a mild saline solution. Fill a small cup with water, then press it firmly against your eye area and allow the water to wash over your eye. The bottom edge of the cup should rest against the edge of your eye socket bone when you do this.
  • Blink several times. This may help the water wash any particles out of your eye. 
  • Gently pull your upper eyelid over your lower eyelid. This will cause tearing in your eye and may dislodge any remaining particles. Your lower eyelashes may also brush the particles out of your eye if they got stuck under your eye. 

What Not to Do

If you think you have a corneal abrasion, do not:

  • Rub your eye. Any contact will make the irritation in your eye worse and may cause new or deeper scratches. 
  • Pick any debris out with your fingers or tweezers. You are unlikely to succeed and may make the problem worse. 
  • Wear your contact lenses. You will need to go without your contacts until your abrasion heals. 
  • Apply eye makeup around your injured eye. Applying makeup in that area will not only be painful but may also put your eye at risk of infection. 

Diagnosis

Eye doctors diagnose corneal abrasions with a simple visual test. They apply special eye drops to your injured eye. The drops contain fluorescein dye, a type of eye stain.

Then they have to blink your eye several times to help spread the drops, which they want to coat the eye. Once the dye is evenly distributed across the surface of your eye, your doctor will use a special light to see where the dye has settled.

When a corneal abrasion is present, the dye will fill in the scratched area and turn it green. This allows your eye doctor to confirm that the scratch exists and determine its size and location. Both factors may have an impact on the recommended course of treatment. 

Treatment Options

Most corneal abrasions heal without medical treatment. If needed, treatments include:

  • An eyepatch. This will cover your cornea and protect it from further injury. It also reduces the urge to blink, which may make your abrasion worse.
  • A special contact lens. This serves the same functions as an eyepatch but will allow you to see using the scratched eye while it heals. 
  • Moisturizing lotion or eyedrops. The treatments can soothe some of the irritation caused by the abrasion and may make it easier for you to refrain from rubbing at your eye. 
  • Antibiotic ointment or eyedrops. If your eye begins to develop signs of infection, your doctor may prescribe antibiotics to control that infection before it can get worse. If you are prescribed this treatment, it is important to finish the entire course of antibiotics, even if your abrasion heals first.
  • Eyedrops that dilate your pupil. Applying these drops will reduce the pressure on your eye and relieve some of the pain you are experiencing. 

Recovery

Most corneal abrasions heal within one or two days. Large or deep abrasions may take up to a week to heal completely. During the healing process, your symptoms should gradually improve. Eventually, your eye should return to normal.

Outcomes

In most cases, corneal abrasions heal with no long-term effects. Pain dissipates and your vision will be unchanged.

If the abrasion is large, it may scar your cornea or cause lasting changes to your vision. But scarring is rare and unlikely to happen if you seek treatment promptly. 

Complications

Most corneal abrasions heal quickly with no major complications. Some rare complications that might develop due to an abrasion include:

  • Bacterial keratitis (an eye infection).
  • Corneal ulcers (open sores on the cornea that may permanently damage your vision). 
  • Recurrent erosion syndrome (repeated corneal erosions). 
  • Iritis (a painful and dangerous type of eye inflammation). This is most likely to happen when the abrasion was caused by plant matter, such as sticks, wood chips, or leaves. 

Prevention

Most corneal abrasion can be prevented. To keep your eyes safe:

  • Wear protective eyewear when engaging in contact sports, working in hazardous environments, or performing chores that involve exposure to flying debris. 
  • Apply eye makeup with care. It is easy to accidentally make contact with your eye while applying eyeliner, eyeshadow, or other cosmetics. 
  • If you wear contact lenses, always wear them according to your eye doctor’s instructions. Do not wear your contact lenses at night and be very careful when you insert and remove them. 

Corneal Abrasion vs. Corneal Erosion

Corneal erosion is a similar condition to corneal abrasion. In corneal erosion, the top layer of your cornea separates from the layer below it. This often happens immediately after you wake up because of to the force exerted by your eyelid as it opens. 

You are more likely to experience corneal abrasion if you:

  • Experience chronic dry eyes
  • Wear improperly fitted contact lenses 
  • Have a corneal abrasion on their eye

Most cases of corneal erosion are treated the same way corneal abrasions are. Depending on your needs, your eye doctor may prescribe moisturizing ointments, antibiotics, or surgery. 

FAQs

How long does it take for a corneal abrasion to heal on its own?

Most corneal abrasions heal on their own within a day or two. Larger ones may take up to a week to fully heal. Even when healing is projected to take longer, you should still notice an improvement of symptoms within a few days. 

How do you treat a corneal abrasion?

Most corneal abrasions do not require treatment. If yours does, your eye doctor may prescribe an eyepatch, special eye drops, or a protective contact lens. 

Will a corneal abrasion heal on its own?

Corneal abrasions usually heal on their own without medical treatment. If yours does not heal within a few days, call your eye doctor. You may be developing complications that will need medical treatment.

References

  1. Corneal Abrasion and Erosion. (September 2021). American Academy of Ophthalmology.

  2. Corneal Erosions or Abrasions (Scratched Eye). (2022). University of Michigan Health: Kellogg Eye Center.

  3. Management of Corneal Abrasions. (July 2004). American Family Physician.

  4. Corneal Abrasion. (March 2015). Cleveland Clinic.

  5. Corneal abrasion (scratch): First aid. (June 2020). Mayo Clinic.

  6. Corneal Abrasion. (July 2021). StatPearls.

  7. Recurrent Corneal Erosions. (2022). Canadian Association of Optometrists.

  8. Corneal Abrasions | Testing & Diagnosis. (2022). Boston Children’s Hospital.

  9. Corneal Scratches: Care Instructions. (August 2020). MyHealth Alberta.

  10. Corneal Abrasions. (November 2020). Nemours KidsHealth.

  11. Corneal Abrasions. (2018). The University of Texas at Austin University Health Services.

Last Updated March 23, 2022

Note: This page should not serve as a substitute for professional medical advice from a doctor or specialist. Please review our about page for more information.