Corneal Abrasions

Corneal abrasions are scratches or damage to the cornea. They are a cause of red, painful eye. There are some common causes:

  • Contact lenses
  • Foreign bodies
  • Finger nails
  • Eyelashes
  • Entropion (inward turning eyelid)

 

If the abrasion is associated with the use of contact lenses there may be infection with pseudomonas.

An important differential diagnosis to consider is herpes keratitis as this will require treatment with antiviral eye drops.

 

Presentation

  • History of contact lenses or foreign body
  • Painful red eye
  • Foreign body sensation
  • Watering eye
  • Blurring vision
  • Photophobia

Diagnosis

A fluorescein stain is applied to the eye to diagnose a corneal abrasion. This is a yellow-orange colour. The stain collects in abrasions or ulcers, highlighting them.

Slit lamp examination may be used in more significant abrasions.

 

Management

NICE Clinical Knowledge Summaries on red eye say patients with potentially sight threatening causes of red eye should be referred for same day assessment by an ophthalmologist. It may be managed in primary care where there are appropriate skills.

Management in secondary care:

  • Simple analgesia (e.g. paracetamol)
  • Lubricating eye drops can improve symptoms
  • Antibiotic eye drops (i.e. chloramphenicol)
  • Bring the patient back after 1 week to check it has healed
  • Cyclopentolate eye drops dilate the pupil and improve significant symptoms, particularly photophobia. These are not usually necessary.

 

Uncomplicated corneal abrasions usually heal over 2-3 days.

 

Last updated April 2019
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