Corneal abrasion
Encyclopedia : C : CO : COR : Corneal abrasion
- For corneal abrasions in dogs and cats, see corneal ulcer.
Etiology
It is generally caused by trauma, of which there are any number of possible causes, including from a finger 'poked' into an eye or from walking into the branch of a tree. A foreign body getting to the eye may also cause a scratch as the eye is rubbed.Symptoms and signs
Symptoms of corneal abrasion include pain, photophobia, a foreign-body sensation, and a reflex production of tears. Signs include epithelial defects and edema, and often conjunctival injection, swollen eyelids, and a mild anterior-chamber reaction. The vision may be blurred, both from any swelling of the cornea and the excess tears.Diagnosis
Although corneal abrasions may be seen with ophthalmoscopes, slit lamp microscopes provide higher magnification which allow for a more thorough evaluation. To aid in viewing, a fluorescein stain that fills in the corneal defect and glows with a cobalt blue-light is generally instilled first.A careful search should be made for any foreign body, in particular looking under the eyelids. Injury following use of hammers or power-tools should aways raise the possibility of a penetrating foreign body into the eye, for which urgent ophthalmology opinion should be sought.
Treatment
Although small abrasions may require no specific treatment, larger abrasions are typically treated for a few days with a topical antibiotic to prevent infection and a topical cycloplegic to reduce pain and improve comfort. Eye pads used in "pressure patching" may also improve comfort and promote healing by preventing repeated eyelid blinking that may cause further physical distruption to the cornea, but they are generally not applied in contact lens wearers or when the abrasion is at significant risk for infection.Complications
Complications are the exception rather than the rule from simple corneal abrasions. It is important that any foreign body is identified and removed, especially if containing iron as rusting will occur.Occasionally the healed epithelium may be poorly adherent to the underlying basement membrane in which case it may detach at intervals giving rise to recurrent corneal erosions.
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