Corneal Abrasions and Recurrent Erosions

One of the most common injuries of the eye is a corneal abrasion. In this condition the surface layer of the eye (epithelium) is removed by such dangerous intruders as baby's fingernails, tree limbs, bushes, and the like. Abrasions are very painful. They also cause excessive tearing, redness and blurred vision.

 

With proper treatment, corneal abrasions usually heal in a short period of time. Treatment consists of a bandage lens or tight patch to keep the lids from moving and irritating the lens. Pain relievers may be needed for comfort. An antibiotic is instilled into the eye because an abrasion invites infection. Abraded, scratched, infected, painful or red eyes should never be patched at home as this may possibly cause a bacterial infection, corneal ulceration, or is rare instances, loss of sight.

 

In the office a local anesthetic is instilled into the eye for temporary relief and for ease in making a reasonable examination of the injury. Repeated use of the anesthetic can harm the eye and is therefore NOT used in the treatment of abrasions.

 

Permanent loss of vision is very rare with superficial abrasions. It may take several weeks for all the blurriness to resolve, however.

 

It is important to NOT rub the eyes during the healing phase. The new cells have poor connections to the underlying tissue and can easily be rubbed off.  When this occurs, the pain returns and repatching is necessary. Abrasions covering small areas heal rapidly; those covering more than a third of the cornea may take two or more days to completely cover over again.

 

Occasionally, long after an abrasion has healed it recurs spontaneously, often upon awakening in the morning. This is called recurrent erosion and represents an area of epithelium that is not "glued" down well to the deeper parts of the cornea.

 

Treatment for recurrent corneal erosions is similar to that for corneal abrasions. Sometimes we prick the bare surface of the cornea with a needle in order to help form better connections between these two surfaces. Bedtime ointments and other forms of lubrication are also helpful in preventing this troublesome complication. Oral antibiotics are often used for recurrent or slowly healing cases.