Corneal Abrasion: Causes, Symptoms, Diagnosis, and Treatment

What is Corneal Abrasion?

A corneal abrasion is a type of eye injury where the cornea sustains trauma which may be a scratch or tear. The cornea is the clear, outer layer at the front of the eye and it directly covers the pupil, iris and anterior chamber. Corneal abrasions may be minor and heal on their own or more severe and require immediate assessment and treatment. A corneal abrasion may result in blurred vision if the cornea is scarred and infected. Keep reading to learn more about what is a corneal abrasion.

What is the Other Term for Corneal Abrasion?

Corneal abrasion is the medical term for this eye condition. Other colloquial terms include scratched eye or scratched cornea. According to the Cleveland Clinic, corneal erosion is a similar eye condition that occurs when a layer of cells on the cornea's surface loosens from the layer underneath.

What are the Causes of a Corneal Abrasion?

Corneal abrasions can be caused by many things and often happen by accident. The causes of a corneal abrasion include rubbing the eyes too hard, poking the eye with objects, contact lenses and foreign objects in the eye. The corneal abrasion causes and their definitions are listed below.

Rubbing eyes too hard: Rubbing the eyes too hard can cause a scratch on the cornea if there is dirt or debris on the surface of the eye.
Poking the eye with objects: If you accidentally poke your eye with a fingernail or object, it can cause a scratch on the cornea.
Contact lenses: Contact lenses can cause a corneal abrasion if they are dirty, too dry or have a torn or rough edge.
Foreign objects in the eye: A corneal abrasion is often the result of a foreign object in the eye scratching the surface.

1. Rubbing Eyes Too Hard

Rubbing the eyes too hard can cause a scratch on the cornea if there is dirt or debris on the surface of the eye. While it may feel good to rub your eyes, it can cause more damage to the surface of the eye. If you feel there is something in your eye causing irritation, try and flush the eye out with water.

2. Poking the Eye with Objects

If you accidentally poke your eye with a fingernail or object, it can cause a scratch on the cornea. This can often happen with children when they are playing with toys. Also, they may accidentally scratch their eyes if their fingernails are long which is why parents should try to clip them regularly.

3. Contact Lenses

Contact lenses can cause a corneal abrasion if they are dirty, too dry or have a torn or rough edge. Contact lenses should only be worn according to their instructions such as daily or extended wear to prevent scratches or eye irritation. If your contact lenses are too dry, you can use a contact lens solution to add moisture. According to an article published in the National Library of Medicine, wearing contact lenses for a prolonged amount of time or if your contact lenses are damaged, can increase a person’s risk of a scratched cornea.

4. Foreign Objects in the Eye

A corneal abrasion is often the result of a foreign object in the eye scratching the surface. Foreign bodies that may cause a corneal abrasion are anything that should not be in the eye including a wood chip, dust, metal shavings, an insect or a piece of glass, according to Better Health Victoria. Foreign objects or bodies in the eyes can cause pain, watery eyes, blurry vision and photophobia. If you have a foreign object in the eye, seek medical attention from an optometrist or other health care professional.

What are the Corneal Abrasion Risk Factors?

Risk factors for corneal abrasions include wearing contact lenses, working around eye hazards and playing sports, according to the Cleveland Clinic. These risk factors and their definitions are listed below.

Wearing contact lenses: Contact lenses can cause a corneal abrasion, especially if they are dirty or too dry. Also, if contact lenses have rough edges they can scratch the eye.
Working around eye hazards: People who work with machines such as grinding machines and sawmills, have a higher risk of an object or dust entering their eye and scratching their cornea.
Playing sports: Playing sports can make a person more at risk of having a corneal abrasion which is why it is recommended to wear safety glasses when playing certain sports.

How Common is Corneal Abrasion?

A corneal abrasion is a common eye condition that can happen to anyone. According to the American Academy of Family Physicians, 8% of all eye presentations in primary care consist of corneal abrasions.

Is a Scratched Eye Common in Kids?

Yes, according to Nemours KidsHealth, a scratched eye or corneal abrasion is a common type of eye injury in kids, teens and also adults. Children may scratch their eyes when playing with toys or if they have long fingernails. Parents should try and clip their child’s fingernails to prevent them from scratching their eyes.

A child with a scratched eye that has caused their eye to become
red.

Is Corneal Abrasion a Rare Corneal Condition?

No, a corneal abrasion is not a rare corneal condition, rather it is a common eye injury that is typically minor and will heal on its own. A corneal condition affects the cornea, which is the clear, outer layer of the eye. Other corneal conditions include keratitis, pterygium, corneal dystrophy and corneal ectasia.

What are the Symptoms of a Corneal Abrasion?

The cornea abrasion or eye scratch symptoms can differ depending on the severity of the scratch. The symptoms of cornea abrasion include photophobia, blurry vision, pain in the eye, red eyes and watery eyes. These symptoms and their definitions are listed below.

Photophobia: Photophobia, also known as sensitivity to light, is one of the main symptoms of corneal abrasions.
Blurry vision: A corneal abrasion may lead to blurry vision due to the disruption to the surface of the eye.
Pain in the eye: A corneal abrasion can cause pain in the eye which may be mild or severe depending on the scratch.
Red eyes: A person’s eye may become red if they have a scratched cornea due to the trauma on the eye's surface.
Watery eyes: A person may experience watery eyes due to a scratched cornea as tears help the eyes heal when they sustain trauma.

1. Photophobia

Photophobia, also known as sensitivity to light, is one of the main symptoms of corneal abrasions. Photophobia is described as being abnormally sensitive to light and is a common symptom of many eye conditions. According to an article published in the National Library of Medicine, photophobia caused by corneal abrasion can be treated with cycloplegic medications which can be in the form of eye drops.

2. Blurry Vision

A corneal abrasion may lead to blurry vision due to the disruption to the surface of the eye. According to the National Library of Medicine, a person’s vision should return to normal once the corneal abrasion is healed, which typically takes 24-72 hours. Blurred vision can also be a complication of a corneal abrasion due to scarring, as discussed by the Royal Victoria Eye and Ear Hospital. If you experience blurry vision from a corneal scratch, visit an optometrist to have your eyes assessed.

A person with blurry vision caused by a corneal abrasion.

3. Pain in the Eye

A scratched cornea can often result in pain in the eye due to the sensitivity of the area. Pain is typically not felt for a small scratch, however, if the scratch is more severe it can be painful and uncomfortable. Medicine can be taken to relieve pain if necessary. According to an article published in the National Library of Medicine, this may include oral nonsteroidal anti-inflammatory drugs. If you are experiencing pain in the eye, you should book an appointment with an optometrist so they can assess your condition.

4. Red Eyes

A person’s eye may become red if they have a scratched cornea due to the trauma on the eye's surface. Red eyes generally describe the surface of the eyes becoming red due to trauma that causes the small blood vessels under the surface of the eye to become large or inflamed, according to the Cleveland Clinic. Redness in the eye will often go away on its own although may be helped with rest, using a cold compress and eye drops.

5. Watery Eyes

Watery eyes or excessive tearing can be a symptom of a corneal abrasion. A person may experience watery eyes due to a scratched cornea as tears help the eyes heal when they sustain trauma. Once the abrasion has healed, watery eyes will often go away on their own without treatment.

How is a Corneal Abrasion Diagnosed?

A corneal abrasion is typically diagnosed in an eye test. An optometrist, sometimes known as an eye doctor, will ask about the history of the injury and if there is any pain you have been experiencing. You will also be asked what other symptoms you are experiencing. Symptoms of a corneal abrasion include photophobia, blurry vision and a gritty feeling in the eyes. Diagnosis can also be achieved through fluorescein dye which is placed on the surface of the eye to highlight where an injury or scratch has occurred on the cornea.

Can an Optometrist Diagnose a Corneal Abrasion?

Yes, an optometrist can diagnose a corneal abrasion in an eye test. An optometrist is your first stop for fundamental eye care. If you feel like you have a scratch on your cornea or feel there is something in your eye, book an appointment with an optometrist and they can provide diagnosis and treatment plans if needed.

How Dangerous is a Corneal Abrasion?

A corneal abrasion is not often a dangerous eye condition as they typically heal on their own. However, it can be a more serious eye injury that needs immediate medical attention, especially if there is a foreign body penetrating the eye.

Can Corneal Abrasions Lead to Blindness?

Although rare, corneal abrasions may lead to blindness if they are untreated, according to an article published in the National Library of Medicine. Otherwise, the prognosis of corneal abrasions is typically excellent if treatment is prompt. A person’s vision can be affected if a corneal abrasion becomes infected, although this again is rare.

Should I Go to the ED for a Corneal Abrasion?

Most cases of corneal abrasion do not necessitate going to the ED. However, in severe cases, this may be advised, for example, if there is a foreign body that needs to be removed from the eye or if a person is experiencing significant pain.

What are the Treatments for Corneal Abrasion?

Scratched eye treatments can depend on the type of corneal abrasion as many do not need treatment and will heal on their own. When treatments for corneal abrasions are needed, they can include eye drops and antibiotics and a healthcare professional may remove the foreign body. The process for how to treat a scratched eye is listed below.

Eye drops: Eye drops may be used to treat a corneal abrasion. According to the American Academy of Ophthalmology, moisturising eye drops add a soothing layer over the cornea. There are also dilating eye drops used to decrease pain.
Antibiotics: Antibiotics may be prescribed by an optometrist to prevent an eye infection. There are different options available for antibiotics according to the National Library of Medicine. This includes ointments and eye drops.
Remove foreign body: If there is a foreign body in the eye, an optometrist or other health care professional may remove the foreign body if it is safe. This can prevent the cornea from becoming more scratched or irritated.

How Long Does Corneal Abrasions Take to Heal?

Most corneal abrasions will take approximately 24 to 72 hours to heal, according to the American Academy of Family Physicians. A corneal abrasion will also typically heal without treatment although it depends on the severity of the injury. Minor eye scratches from dust or debris do not require treatment as they will heal with time.

Does Sleep Help Heal Corneal Abrasions?

Yes, sleeping may help heal a corneal abrasion according to Medical News Today. Sleep can be effective in helping a corneal abrasion as it can speed up a body’s healing process. Sleep also means the eyes are closed and will most likely not be rubbed or blink which can cause further irritation.

Can Eye Drops Treat a Corneal Abrasion?

Yes, eye drops are often prescribed to treat a corneal abrasion. These eye drops can include antibiotic eye drops which provide lubrication to the eye according to the National Library of Medicine. There are also Cycloplegic eye drops which are used to manage photophobia (light sensitivity) which may be caused by a corneal abrasion. Dilating eye drops may be prescribed to treat pain caused by a scratched cornea.

A person putting eye drops in their eye to treat a corneal
abrasion.

What are Ways to Prevent Corneal Abrasions?

There are certain preventative measures a person can take to avoid corneal abrasions. The ways to potentially prevent corneal abrasions include wearing protective eyewear, not rubbing your eyes and clipping your child’s fingernails. These preventive measures and their definitions are listed below.

Wear protective eyewear: Make sure to wear protective eyewear when working in hazardous conditions or when playing a sport that requires them. This can prevent the surface of the eye from being scratched.
Don’t rub your eyes: If there is a foreign body such as dirt or sand in your eye, you should not rub your eyes as it can cause scratches on the cornea. While you may feel compelled to rub your eyes, try flushing the eyes with water instead.
Clip children’s fingernails: Children can accidentally scratch their eyes with their fingernails if they are too long. Parents should clip their children’s fingernails to prevent corneal abrasions.

Can Glasses Prevent a Corneal Abrasion?

Yes, in some cases, glasses, specifically safety glasses or goggles, can prevent corneal abrasions. Corneal abrasions can occur when working in a hazardous environment or with certain machines such as a sawmill. Sunglasses can also help keep dirt or debris out of a person’s eyes in windy environments.

What is the Difference Between a Corneal Abrasion and Keratitis?

While corneal abrasions and keratitis are both corneal diseases, they have many differences. A corneal abrasion is a scratch on the cornea and keratitis is inflammation in the cornea. Keratitis is an eye condition that affects the cornea and is also known as a corneal inflammation or corneal infection. Keratitis can be caused by a virus, an eye injury or bacterial, fungal and parasitic infections. A corneal abrasion and keratitis have similar symptoms including photophobia, excessive tearing, blurry vision and pain in the eye.

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