Corneal abrasions

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Last reviewed: June 2019

Last updated: March 2018

Summary

Onset is usually sudden, and typical symptoms include a foreign body sensation (even if none present), photophobia, excessive tearing, blepharospasm, and blurry vision.

Treatment involves adequate analgesia and topical antibiotics. Contact lens wearers are at increased risk of Pseudomonas infection.

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

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

Complications are rare but include corneal ulceration and keratitis.

Definition

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. Patients who have had a previous injury and structural defects to the corneal epithelium are at risk for spontaneous abrasions known as recurrent erosions.

History and exam

Key diagnostic factors

presence of risk factors
eye pain
tearing
photophobia
blurred vision
ciliary flush

Full details

Other diagnostic factors

presence of foreign body
corneal opacity
rust ring
blepharospasm

Full details

Risk factors

eye trauma
foreign body in the eye
contact lens use
working in the automobile industry
lack of protective eyewear
prior corneal abrasion
deployment of air bag during automobile collision

Full details

Diagnostic investigations

1st investigations to order

visual acuity
fluorescein staining

Full details

Investigations to consider

CT scan of orbits

Full details

Treatment algorithm

ACUTE

acute corneal abrasion

ONGOING

recurrent corneal abrasions or poor healing

Contributors

Authors VIEW ALL 

Christopher McStay, MD

Christopher McStay

Associate Professor of Emergency Medicine

Department of Emergency Medicine

University of Colorado School of Medicine

Aurora

CO

Disclosures

CM declares that he has no competing interests.

Peer reviewers VIEW ALL 

Christopher Tedeschi, MD

Instructor in Clinical Medicine

Emergency Medicine Department

New York Presbyterian Hospital

Columbia University Medical Center

New York

NY

Disclosures

CT declares that he has no competing interests.

Rasik Vajpayee, MD

Chair of Ophthalmology

Corneal and Cataract Surgery

University of Melbourne

Melbourne

Australia

Disclosures

RV declares that he has no competing interests.

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