Corneal abrasions

Corneal abrasions usually have a sudden onset. Typical symptoms include a foreign body sensation (even if none present), photophobia, excessive tearing, blepharospasm, and blurry vision.

Patients with previous injury or structural defects of the corneal epithelium may develop abrasions known as recurrent erosions (these may appear to be spontaneous and have no obvious cause).

Treatment involves adequate analgesia and topical antibiotics. Contact lens wearers are at increased risk of Pseudomonas infection and require broad-spectrum antibiotic prophylaxis.

Most abrasions heal within 1 or 2 days and have few sequelae.

Larger defects, or those associated with contact lens use, should have ophthalmologic follow-up in 1-2 days to ensure healing.

Complications are rare but include superinfection, which can lead to corneal ulceration and scarring.

Corneal abrasions are corneal epithelial defects. They are common and are typically caused by mechanical trauma from external objects such as fingernails and branches, foreign bodies that become lodged underneath the eyelids, or contact lens use. Recurrent corneal erosions are corneal epithelial defects that occur spontaneously or in patients with a history of previous trauma (e.g., corneal abrasion, eye surgery), underlying structural defects (e.g., corneal dystrophies), or risk factors that reduce the protective mechanisms of the eye (e.g., dry eye disease, diabetes).[1]Miller DD, Hasan SA, Simmons NL, et al. Recurrent corneal erosion: a comprehensive review. Clin Ophthalmol. 2019 Feb 11;13:325-35. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6376883 http://www.ncbi.nlm.nih.gov/pubmed/30809089?tool=bestpractice.com ​