How to treat corneal abrasions

Corneal abrasion as stained with fluorescein (yellow)

A corneal abrasion is a scratch on the surface of the eye, resulting in a defect in the epithelium — the topmost of the 5 layers of the cornea. The most common cause of a corneal abrasion is trauma (fingernail, ball, etc.) and it can be very painful. Once the epithelium is unroofed, thousands of nerve endings are exposed and lead to light sensitivity, pain and tearing.

Healing is fast

The good news about an abrasion is that they usually heal very quickly. In a normal eye, a complete corneal abrasion (meaning the entire epithelial surface is missing) will heal over in about 4 days. More commonly, abrasions are smaller than the entire eye surface and will likely be better within 24 hours.

5 layers of the cornea

Treatments

My favorite treatment for corneal abrasions are antibiotic ointments (like erythromycin). Ointments are nice in that they coat the corneal surface, protecting the exposed nerve endings and reducing pain and discomfort. If the patient is a contact lens wearer (and therefore more prone to getting corneal infections), I use a fourth generation fluroquinolone antibiotic eye drop.

What to do

If you get hit in the eye and think you may have a corneal abrasion, it is best to seek immediate medical attention and have a full eye exam (including dilation of the pupils). Your ophthalmologist will be able to make sure that all you have is a corneal abrasion and nothing worse — like a torn retina, retinal detachment, bleeding in the eye (hyphema or vitreous hemorrhage), torn iris, or some other potentially visually threatening condition.

Once everything looks good, you’ll get a prescription for an antibiotic and will hopefully be better in a day or two.