Corneal injuries: lacerations and erosions

Medical content revised by - Last revision 13/11/2017
Corneal injuries: lacerations and erosions

CORNEAL LACERATION


What is a corneal laceration?

A corneal laceration is a cut on the cornea, normally caused by a sharp object coming into contact with the eye. It can also be the result of the eye receiving a strong impact from an object, such as a metal tool. For this reason it is important to wear protective glasses when carrying out potentially hazardous activities, such as cutting wood or metal.

A corneal laceration is deeper than a corneal erosion, and can involve a partial or total cut to the cornea. If the laceration is very deep, it may penetrate the full thickness of the cornea. In this case, the laceration passes through the whole cornea and causes a tear in the eye ball.

Corneal lacerations are serious lacerations that require urgent medical attention to prevent major vision loss.


What to do in cases of corneal laceration

If you have suffered an eye injury you should try to follow these steps:

  • Place an eye protector over the eye without allowing it to touch the eye and tape it in place until you receive medical attention.
  • Do not rinse with water
  • Do not remove any object that has become embedded in the eye.
  • Do not rub the eye or apply any pressure to it.
  • Avoid taking aspirin, ibuprofen or other non-steroidal anti-inflammatory medication, as this dilutes the blood and may increase the risk of haemorrhage.

Once the eye has been protected, go to accident and emergency immediately.


What are the symptoms of a laceration?

The symptoms of a corneal laceration can be as follows:

  • Intense pain
  • Eye watering
  • Sensitivity to light
  • Blurred or reduced vision
  • Haemorrhage (blood in the eye)
  • The sensation of a foreign object in the eye.

What is the treatment for a corneal laceration?

To close a corneal laceration, surgery is normally carried out, which helps to prevent further damage to the eye and to remove any foreign body that may have become embedded in the area following the trauma.

Serious lacerations may require repeated surgery and may even cause permanent loss of vision.

After surgery, it is possible that you may need to keep the eye covered in order to protect it. In addition, your ophthalmologist will prescribe the necessary medication, which may include painkillers and drugs to help your wound heal.

Corneal lacerations may also carry a risk of complications, including detached retina, infections or glaucoma. This is why it is essential to have check ups after the initial treatment.


CORNEAL EROSION


What is a corneal erosion?

A corneal erosion is a scratch on the cornea. These are normally superficial and do not leave a scar.

Corneal erosions can often be avoided by using protective glasses when carrying out risky activities.

Small children are one of the most common causes of corneal erosions because they often accidentally poke their finger in the eye of whoever is holding them.

In some cases, the cause of the corneal erosion may not be clear, as the symptoms may appear hours after the corneal injury.

These erosions have a wide range of different causes, including:

  • Objects that hit or enter the eye, such as plant matter, sawdust or ash;
  • Foreign bodies, such as dust, dirt or sand, that become stuck under the eyelids;
  • Injuries caused by practising sports
  • Use of badly fitting or incorrectly stored contact lenses;
  • An object entering the eye;
  • Excessive rubbing of the eyes, especially if there seems to be something stuck in your eye;
  • Some eye illnesses, such as trachoma, a bacterial infection

Surgery under general anaesthetic.


Symptoms caused by corneal erosion

When a corneal erosion occurs, the following symptoms may be present:

  • pain, which may increase on opening and closing your eyes;
  • the sensation of a foreign body in your eye
  • reddening
  • watery eyes
  • sensitivity to light
  • blurred vision or loss of vision
  • headache

On some occasions you may not be aware that you have suffered a corneal erosion or know how it has happened, as the symptoms can appear hours after the injury.

If you notice that something blows into your eye, try to rinse it out with tap water. Remember not to rub your eyes, as this may worsen the erosion.


Treating corneal erosion

A smaller corneal erosion will usually close by itself in a few days. Your ophthalmologist may prescribe drops or an antibiotic ointment in your eyes, or use steroid drops to reduce inflammation and the likelihood of scar formation.

If you have suffered from corneal erosion, the doctor may cover your eye so that you feel more comfortable or prescribe painkillers. It may also be useful to wear sunglasses to reduce the symptoms of corneal erosion during the healing process.

If you wear contact lenses, you should avoid wearing them until your ophthalmologist confirms that it is safe to start wearing them again.

In some cases, days or months after healing, the injury may suddenly return. This normally occurs after sleeping. In this case, you should seek treatment again and use a preventative lubricating treatment.

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