Eye Education

Steps for Treating a Corneal Abrasion

You know that feeling when you get an eyelash stuck under your contacts — like the serrations of a butter knife scraping across your eyeball? What if you felt that way and you couldn’t see what was causing the pain?

You might have a common eye injury called a corneal abrasion. If you wear contacts, your risk of developing it is higher than most people’s.

What does it mean to have a corneal abrasion?

A corneal abrasion is a scratch on the clear covering of your eyeball (the cornea). This thin dome protects the iris, pupil and whites of your eye from damage. It can get scratched or scraped by anything that comes into contact with your eyeball.

In fact, most scratched corneas aren’t caused by accidents like poking your eye with a finger or a makeup brush. They’re usually due to smaller particles that you can’t see getting trapped in your eye or under your contact lenses and scraping your cornea.

A scratched eye tends to feel really painful because there are lots of nerve endings in your cornea, making it sensitive to even minor damage. It’s actually a pretty cool evolutionary trick— you feel a disproportionate pain response so your brain knows there’s something in your eye before it can damage deeper structures like the pupil or iris.

Contact lens wearers may be at a higher risk for a scratched cornea because our corneas become less sensitive the longer we wear contacts. Basically, since we’re always popping lenses (and fingers) in our eyes, we’re less likely to notice if something else ends up in there, too. And if you don’t clean or replace your contacts regularly, your risk of a scratched eye goes even higher.

How can I tell if I have a corneal abrasion?

If you feel like there’s a big, painful thing stuck in your eye but you can’t see it, you might have a corneal abrasion. Since the cornea is so sensitive, even small scratches can make you feel like there’s something gritty or irritating rubbing across your eyeball.

Other scratched cornea symptoms include:

  • Eye pain or achiness
  • Redness
  • Sensitivity to light
  • Eye twitches
  • Tearing or blurry vision
  • Headaches

If you notice corneal abrasion symptoms like these, gently flush your eye with distilled water or saline solution, then seek help from a professional.

Should I go to the doctor if I have a scratched cornea?

Yes! If you think you have a scraped cornea, the best way to know for sure is to see your eye doctor. They can do a test that uses a safe fluorescent dye to identify a corneal abrasion and see how serious it is.

If your eye exam shows a scratched cornea, your doctor might prescribe medication to treat the scratch and make you more comfortable. This could include antibiotic eye drops to lower the chances of an infection, artificial tears to help keep your eyes moist and comfortable, or anti-inflammatory medications to reduce pain and irritation.

Your doctor also can help you treat or prevent a more serious condition like a corneal ulcer, which can happen when an abrasion gets infected.

How do I treat a corneal abrasion?

Even though your first instinct might be to rub your eye, don’t! Rubbing could make a corneal abrasion worse. Instead, blink a few times and flush your eyes with saline or multipurpose contact solution to move particles out of your eye.

If it’s minor, a corneal abrasion might heal on its own without treatment. For a more serious scratch, your doctor might prescribe medicated eye drops or ointments to keep infection at bay, and painkillers to reduce discomfort while your eye heals.

They’ll also probably advise you not to wear contacts for at least a week after treatment. The new corneal tissue will be developing as the abrasion heals, making it vulnerable to infection. And contacts can trap bacteria on the surface of your eye, raising your risk of an infection called bacterial keratitis.

If you have a deep scratch in the middle of your cornea, however, your doctor might give you a bandage contact lens. These disposable contacts aren’t for correcting your vision. Instead, they protect the cornea as it heals.

How can I prevent a corneal abrasion?

While you can’t predict all of the ways that an accident or injury could lead to a corneal abrasion, there are plenty of ways to lower your risk.

  • Take good care of your contacts. Make sure to clean your lenses thoroughly and replace them on schedule. Otherwise they could rip and cause a scratched eye or trap debris on the surface of your eye that could lead to a corneal abrasion.

  • Prevent dry eyes. Sometimes corneal abrasions happen because your eye surface isn’t properly moisturized with tears, causing the skin of your eyelid to stick to or scrape across the surface of your eye. You can lower the risks associated with dry eyes by staying hydrated and using moisturizing eye drops that act as artificial tears.

  • Wear protective eye gear. Put on safety glasses when you’re doing yard work or otherwise exposed to ash, dirt and other particles that could scratch your eye. It’s also a good idea to wear protective eyewear if you play sports, use power tools, work with chemicals, or do outdoor activities that could raise your risk of a corneal abrasion.

  • Make sure your eyes are protected during surgery. Corneal abrasions are a potential complication when you have surgery that uses general anesthesia. If you’re considering a procedure that requires you to be put under, talk to your doctor about how to protect your eyes.

Now that you’re a corneal abrasion pro, make sure you get your annual eye exam scheduled so your doctor can check on the health of your eyes. If you’re a contact lens wearer, Sightbox covers your annual exam, contact lens fitting and a year’s supply of lenses. Sign up or learn more today.