Updated on  April 29, 2024
7 min read

Corneal Abrasion: Understanding Scratched Cornea

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If you’ve ever had a corneal abrasion, you know how painful these common eye injuries can be. A corneal abrasion can occur in an instant when something scratches your eye.

Corneal Abrasion illustration edited

In general, corneal abrasions are not serious or life-threatening. Many minor corneal abrasions heal within 1 to 3 days. 

What is a Corneal Abrasion?

A corneal abrasion occurs when you get a superficial scratch on the cornea. The cornea is a transparent and protective layer that sits on the eyeball. 

The cornea is filled with many nerve fibers. This means that anything that disrupts the corneal surface can cause pain or irritation. 

If you have a corneal abrasion, your eye may have come in contact with:

  • Dust 
  • Dirt
  • Sand
  • Wood shavings
  • Metal particles 
  • Twigs, pine needles, or other plant matter

Without proper treatment, a corneal abrasion can develop into a corneal ulcer. Call your eye doctor if you believe you have a corneal abrasion and are unsure about its severity.

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When to See a Doctor for Treatment

Most minor corneal abrasions heal on their own. You may need to see an eye doctor for treatment. 

You should seek medical care if you experience any of the following:

  • Eye pain
  • Change in vision (e.g., decreased vision)
  • Increased light sensitivity
  • Foreign objects in the eye or around or under the eyelid
  • High-speed or high-force eye trauma

How is Corneal Abrasion Diagnosed?

To diagnose a corneal abrasion, your ophthalmologist will ask about your symptoms and examine your eye. They’ll use a slit-lamp biomicroscope to shine a high-powered light into your eye. This helps them identify any surface scratches. 

Your ophthalmologist may use a special dye and light to confirm the diagnosis.

  1. If needed, your doctor applies a topical anesthetic to numb your eye
  2. They insert fluorescein dye into your eye and shine a cobalt-blue filtered light on it
  3. If a corneal abrasion is present, it will appear green
  4. If there are any foreign bodies in your eye, your doctor will remove them

How is a Corneal Abrasion Treated?

Treatment options for a corneal abrasion include:

  • Moisturizing eye drops (artificial tears) or ointments. These increase comfort by soothing the cornea.
  • Prescription topical antibiotics. Your doctor may prescribe antibiotic drops or ointment to prevent infection.
  • Dilating eye drops. A special type of dilating eye drop called cycloplegic can relieve light sensitivity.
  • Bandage contact lens. Your doctor may give you a special contact lens that acts as a bandage over your eye. It’s important to avoid wearing your regular contact lenses until your eye has healed.
  • Topical analgesics. Topical nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve eye pain.
  • Sleep. Sleep allows the body to rest and restore immune defenses. Additionally, closing your eyes will minimize irritation to the injured area. 

While your doctor may apply a topical anesthetic during your initial exam, they won’t prescribe these as treatment. Continued use of anesthetic drops can slow healing and cause damage.

Corneal Abrasion Healing Time

Most corneal abrasions fully heal within a few days. You may have blurry vision until your eye heals completely. Your vision should return to normal when the healing process is complete, unless the abrasion leaves a scar.

How Long Does it Take for Corneal Abrasion to Heal?

If the injury is minimal, it will heal completely in about 1 to 3 days. A larger, scratched cornea may undergo an extended healing process (about a week).

Your ophthalmologist will probably want to see you a day or two after your initial visit to ensure your cornea is healed.

Does a Corneal Abrasion Ever Heal Completely?

Yes—corneal abrasions typically heal without further problems. However, your corneal surface may not be as smooth as before the injury.

Corneal abrasion also increases your risk for corneal erosion. Ongoing eye irritation after your corneal abrasion heals can be a symptom of a problem with the corneal epithelium. Call your eye doctor if this happens.

Treatment for corneal erosion is like that for corneal abrasion. But if you get corneal erosion two or more times, your doctor may recommend surgery.

What are the Symptoms of a Corneal Abrasion?

The cornea holds many nerve cells called pain receptors. When something scratches the eye, these cells emit the sensation of pain and let you know of possible corneal injuries. 

This condition can be particularly painful because the cornea has the highest densities of nerve endings, significantly more than those found in the skin.

Corneal abrasion symptoms include:

Your cornea has at least a hundred times more pain receptors than those in your skin. 

What Does Corneal Abrasion Look Like? 

A simple corneal abrasion is a superficial scratch to the corneal surface. Because it can cause irritation and inflammation, the sclera (white part of the eye) may turn red. 

image 17

A healthcare professional may perform a diagnostic test using a dye to determine if you have a corneal abrasion. The dye will illuminate the scratched area. 

Corneal Abrasion vs. Ulcer

A corneal abrasion is not the same as a corneal ulcer. However, a corneal abrasion may result in a corneal ulcer. 

A corneal ulcer refers to an open sore on the cornea. It develops with an eye infection, severe dry eye, or other eye disorders. 

All corneal injuries carry a risk of infection. Damage to the corneal surface leaves it exposed to viruses, bacteria, and fungi. For this reason, an ophthalmologist may prescribe preventive antibiotic eyedrops for a corneal abrasion to minimize the likelihood of that event. 

Additionally, while a corneal abrasion is minor in most cases, a corneal ulcer may cause severe eye health problems. If you have a corneal ulcer, you should seek medical attention immediately to receive proper treatment. 

Corneal ulcers can harm your vision if left untreated and result in permanent vision loss.

Corneal Abrasion vs. Corneal Erosion

Some people confuse corneal abrasion with corneal erosion. Both conditions are painful and can cause blurred or hazy vision. However, the latter occurs because the corneal epithelium (layer of cells that run across the cornea surface) begins to break free from the underlying layer.

You’re more likely to experience corneal erosion if you’ve had a corneal abrasion or a corneal disease, such as corneal dystrophy.

What Causes Corneal Abrasion?

Corneal abrasions can occur for different reasons. 

You could get a corneal abrasion from:

  • Tree branches
  • Make-up brush
  • Workplace debris 
  • Airborne debris
  • Sports equipment
  • Sand or other small particles 
  • Foreign objects
  • Prolonged use of contact lenses
  • Damaged contact lenses

If you get sand or something small in your eye, do not rub it. Wash your eye out with saline solution or water instead. Rubbing can worsen the problem and make it easier for corneal injuries to occur. 

Is a Corneal Abrasion Serious?

Most corneal abrasions are minor, healing within 1 to 3 days. If you experience persistent symptoms from a corneal abrasion, seek immediate medical care. 

A corneal abrasion can lead to a corneal ulcer or even degenerative eye disease if you do not receive proper treatment.

To prevent a corneal abrasion from worsening:

  • Don’t try to get rid of an object lodged in the eyeball 
  • Don’t rub the eye after an injury
  • Don’t touch your eyeball with cotton swabs, tweezers, or other items
  • Don’t wear contact lenses while your eye is healing

Are Corneal Abrasions Preventable? 

To avoid getting a scratched cornea, you should:

  • Wear safety goggles or other eye protection, especially when working outdoors or with wood or metals
  • Clip children’s and pets’ nails 
  • Be careful with eye makeup or other beauty products when applying 
  • Follow care instructions for contact lenses

Summary

  • Corneal abrasions are common eye injuries that are usually very painful
  • Most corneal abrasions are minor and heal in 1 to 3 days
  • Larger corneal abrasions can take longer to heal and may increase your risk for corneal ulcers or corneal erosion
  • Your eye doctor may prescribe topical ointments, and eye drops to prevent infection and relieve your symptoms
  • It’s normal to have blurry vision while your corneal surface heals
  • Vision should return to normal when the healing process is complete
Updated on  April 29, 2024
6 sources cited
Updated on  April 29, 2024
  1. Boyd, Kierstan. “Corneal Abrasion and Erosion.” American Academy of Ophthalmology, 2022.
  2. Corneal Abrasion (Scratch): First Aid.” Mayo Clinic, 2022.
  3. Corneal Abrasion (Scratched Eye): Diagnosis & Treatment.” Cleveland Clinic, 2015.
  4. Corneal Abrasion.” Yale Medicine, nd.
  5. Domingo, Emilissa. “Corneal Abrasion.” StatPearls, 2022.
  6. Wilson, SA, and Allen, L. “Management of Corneal Abrasions.” American Family Physician, 2004.
The information provided on VisionCenter.org should not be used in place of actual information provided by a doctor or a specialist.