Everyone has, at one point or another, scratched their eye subconsciously due to the feeling of irritation around the area. Most of the time, people get lucky and nothing major really happens but for others, this may result to an eye injury called a corneal abrasion.
Abrasion, from the root word ‘abrade,’ means the scraping or wearing away of an external part by friction or erosion. In relation to this, corneal abrasion occurs when the cornea is scraped or scratched, resulting in the loss of epithelial cells which serve as a lining on the top layer of the cornea. This is one of the most common types of eye injury.
The cornea is located on the front of the eye and serves as a transparent cover for the iris and pupil. The cornea has two main functions. The first function is to allow light to enter and penetrate the eye. The second function is to focus the eye on certain objects - an action it does together with the lens of the eye. The cornea has a certain curvature that allows proper focusing. If that curvature deviates from the optimum amount, nearsightedness, farsightedness or astigmatism may develop. With these things in mind, a healthy cornea is needed to have good visual acuity.
A scratched cornea would of course be expected to disrupt normal vision. So, how can you get this type of eye injury?
At the simplest form, you can get a corneal abrasion from any object or any method that may come into contact with the surface of your eye. A common example would be a finger rubbing the eye. Flying debris, accidental pet scratches, sports equipment, makeup brushes or twigs may also cause abrasion and are large enough to cause trauma when applied to the eye. As mentioned earlier, sand, dust and other airborne particles may cause corneal abrasion as well, especially if these debris are rough-edged and are applied with enough frictional force to tear through the clear layer.
Dry eyes can also cause this, especially during unusually long periods of sleep. The eyelids may adhere to the dried cornea and may tear it apart upon the motion of opening. Damaged contact lenses may abrade the eye as well, especially if continued to be worn for a long time. Wearing contacts for an extended period also poses an increased risk of dry eye.
Take note that any type of injury to the cornea - big or small - may be extremely uncomfortable and painful to touch. You may get the irritating feeling of having something foreign inside your eye constantly, which is why it is even more important to scratch or touch the eye, since this may worsen the condition of the eye.
Symptoms include significant discomfort, reddened eyes and hypersensitivity to light. Tearing, headache, blurry vision, eye twitching and nausea may also be felt.
First of all, never rub your eye vigorously! While there is a possibility that the foreign object can be removed with this method, it is actuality one of the main causes for abrasion. Instead, you may opt to rinse your eye with clean, sterile water or with multipurpose contact lens solution.
Sterile solutions are preferred over tap water as water - both bottled and from the faucet - were found to contain microorganisms which may cause infection. These pathogens were even found to cause vision loss if inadequate treatment is not given beforehand. If you still feel the urge to rub your eye, you can opt to blink continuously for a few seconds to try dislodge the material from the area. Don’t touch your eye with your bare hands since they can contain the most number of pathogenic bacteria due to its contact with the environment around you.
If pain and irritation persists even after adequate rinsing, seek professional help immediately. Infection has a variable time of setting in so it would be best to treat the abrasion as soon as you are able to visit your eye doctor.
Another thing that you should not do is to patch your eye. It may seem as though your are protecting it from damage, but on the contrary you are allowing the eye to become an accommodating environment for the growth and conduction of bacteria. As bacterial numbers increase, the chance of acquiring an infection increases as well.
Visiting Your Eye Doctor
Once you’ve referred the problem to a doctor, you may observe that certain medications are applied for both diagnosis and treatment of your corneal abrasion. Numbing eye drops may be used first for examination and to have a good visualization of the extent of the abrasion when seen under blue light and with an examining microscope. Your doctor will advise you on next steps depending on the severity of the wound and the cause of the abrasion.
Recall exams must be followed in order to track the progression of your treatment. Some may even be as soon as 24 hours after the initial check-up. The cornea has a relatively short period of healing time, so it would be best to monitor the healing process and ensure that everything is going well and that no complications arises from the injury. When treated right away, most abrasions result to a full recovery and restoration of vision with no permanent side effects. So treat that wound right away no matter how simple it may appear to be.
For minor abrasions, it would be better to wait for the natural healing process to do its work. Non-preserved lubricating drops for comfort and moisture may be recommended. An injured eye may have a tendency of drying out easily so these would come in handy for the few days needed for your cornea to recuperate. Sometimes, antibiotic eye drops are also given as a precaution even for simple abrasions especially if your doctor sees that there is an increased chance of acquiring infection based on factors such as work environment and such.
For larger types of corneal abrasion, an antibiotic ointment that can adhere and be exposed to the eye for longer periods of time may be preferred. Steroid creams may be prescribed to decrease the effects of inflammation and scarring, as well as to relieve the pain, itch and light sensitivity of the eye. This type of abrasion which affects a larger area of the eye may have a longer healing time and may even cause corneal scarring which would affect your long-term vision. Bandage contact lenses may also be utilized. As the name implies, these were designed to provide not only pain relief, but also increase the capability and speed of your cornea to heal.
Deep corneal abrasions may turn into corneal ulcers. These are secondary eye conditions which will drastically affect your vision quality as the it worsens. The more centered the location, the worse the prognosis gets. Scars on the cornea can result to a loss of vision acuity.
If you are a contact lens wearer, don’t use them during the period of time that your corneal abrasion needs for adequate healing. Similar to the way that eye patches are not recommended, contact lenses may also increase the risk of infection as the environment under it becomes conductive for the growth of bacteria. Ask for your optometrist’s advice for the best time to resume wearing your lenses.
Prevention is key to avoiding corneal abrasions - such as opting to wear safety glasses in hazardous work environments where debris can be flung easily from one place to another. During sports, safety gear are available in most of the local sports outlets so you can opt to buy those as well for prevention of traumatic abrasions.
If you’re a regular contact lens wearer, make sure to clean them properly using the advised cleaning regimens. Also moisturize your eyes as much as you could to avoid the occurrence of dry eyes. Eye drops can be handy during times when your eyes feel itchy and when there is debris present in the eye area. Use these instead of regular water sources for cleansing.