The onset of corneal abrasions 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.
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
- blurred vision
- ciliary flush
Other diagnostic factors
- presence of foreign body
- corneal opacity
- rust ring
- eye trauma
- foreign body in the eye
- contact lens use
- working in the automotive industry
- lack of protective eyewear
- prior corneal abrasion
- deployment of airbag during motor vehicle collision
1st investigations to order
- visual acuity
- fluorescein staining
Investigations to consider
- CT scan of orbits
acute corneal abrasion
recurrent corneal abrasions or poor healing
Christopher McStay, MD
Associate Professor of Emergency Medicine
Department of Emergency Medicine
University of Colorado School of Medicine
CM declares that he has no competing interests.
Christopher Tedeschi, MD
Instructor in Clinical Medicine
Emergency Medicine Department
New York Presbyterian Hospital
Columbia University Medical Center
CT declares that he has no competing interests.
Rasik Vajpayee, MD
Chair of Ophthalmology
Corneal and Cataract Surgery
University of Melbourne
RV declares that he has no competing interests.
- Corneal laceration with globe perforation
- Corneal ulceration and ulcerative keratitis
- Corneal abrasion
- Corneal (or other superficial ocular) foreign body
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