Corneal injury

Definition
Corneal injury describes an injury to the curved, transparent covering on the front of the eye. See also corneal ulcers and infections.

Causes, incidence, and risk factors

The cornea is the clear covering of the front of the eye. It works with the lens of the eye to focus images on the retina. Injuries to the cornea are common.

Superficial corneal injuries, called corneal abrasions, may be caused by foreign bodies (such as sand or dust), overuse of contact lenses or exposure to ultraviolet radiation. Risk factors include working in a dusty environment, prolonged exposure to the sun or artificial ultraviolet light sources, and overuse of contact lenses or ill-fitting contact lenses.

Penetrating corneal injuries may occur with major trauma. High speed particles, such as chips from hammering metal on metal, are particularly dangerous.

Symptoms

     
  • Blurred vision  
  • Abnormal sensitivity to light  
  • Sensation of foreign body in the eye  
  • Eye pain  
  • Redness of the eye  
  • Swollen eyelids

Signs and tests

     
  • Standard ophthalmic exam  
  • Slit lamp examination of the eye  
  • Fluorescein dye staining of the surface of the eye

Treatment

Anyone with severe eye pain needs to be evaluated in an emergency care center or by an ophthalmologist immediately. Simple corneal injuries are treated by removing the foreign material if present, and covering the eye with a patch to let the cornea heal itself. Antibiotic drops or ointments are often used to prevent infection.

DO NOT try to remove a lodged foreign body in the eye without professional assistance. (See first aid for eye emergencies.) The risk of further injury is great. A particle that is large enough to damage the cornea may not be visible without magnification or staining of the eye.

Antibiotic ointment or drops may be prescribed until a corneal abrasion has healed. Getting rest and placing a patch over the affected eye may help. Driving and other potentially dangerous situations should be avoided while the eye is patched, since depth perception is altered.

Any suspicion of a penetrating injury to the eye requires immediate evaluation by an ophthalmologist or emergency physician.

Chemical burns may occur with acids or alkalis splashed in the eye. Many household chemicals are strong acids or alkalis. Drain cleaners and oven cleaners are particularly dangerous. If chemicals are splashed in the eye, the eye should be IMMEDIATELY flushed with tap water for 15 minutes, and the patient should then be rushed to the nearest emergency facility.

Expectations (prognosis)

Superficial corneal injuries normally heal very rapidly with treatment, and the eye should be back to normal within 2 days. Penetrating corneal injuries are much more serious and the prognosis will depend on the nature of the specific injury.

Complications

Severe corneal injury may require extensive surgery or even corneal transplantation surgery.

Calling your health care provider

Call your health care provider if the injury has not significantly improved in 2 days with treatment.

Prevention

Safety goggles should be worn at all times when using hand or power tools, when using chemicals, during high impact sports, or in other situations where there is a potential for eye injury. Sunglasses designed to screen ultraviolet light should be worn during prolonged exposure to sunlight, even during the winter.

Johns Hopkins patient information

Last revised: December 3, 2012
by Levon Ter-Markosyan, D.M.D.

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