RICE & MICE: Corneal Injuries

Yzerman had a corneal abrasion among some other injuries to his eye

Yzerman had a corneal abrasion among some other injuries to his eye

The cornea is the clear tissue that lays over the iris and pupil of the eye. The cornea works with the lens to help focus images on the retina. Just like any part of the body, injuries can and do occur to the cornea. Injuries to the cornea can be very painful due to the many nerve endings just under the corneal surface.

 

A corneal abrasion is a scratch or scrape on the surface of the cornea.  This may occur when something hits your eye, such as a ball, a finger or other object that can hit the face. Corneal abrasions can also be caused by particles of dust or debris that get in the eye and scrape the surface when you blink. Finally, corneal abrasions could be caused by excessive rubbing of irritated eyes, wearing contacts for longer than recommended or using ill fitting contact lenses. Infection may also cause injury to the cornea which may be temporary or permanent. Over exposure to ultraviolet light from tanning beds, sun lamps or welding arcs can cause damage to the surface of the cornea. Chemical irritation may also cause sometimes severe damage to the eye.

Symptoms of a corneal injury include sensitivity to light, blurred or decreased vision, pain, stinging or burning sensation in the eye or feeling like there is something in your eye, redness of the eye, swollen eyelids and watery eyes. Sometimes the eyelids will spasm, making it difficult to open the eye.

A corneal abrasion glowing with flourescein dye. From AAFP

To evaluate eye pain, a complete eye exam should be done, including vision assessment. A special fluorescent dye that glows under blacklight may be used to detect abrasions, ulcers or infection. An example of this can be seen in the picture to the right.

Severe eye pain should be evaluated immediately at an emergency care facility or by an ophthalmologist. Initial treatment when something gets in the eye such as debris or chemicals should involve flushing the eye with clean water for a period of 20 minutes with the eye open and occasionally lifting the eyelids to allow water to flush underneath the lids.

Treatment of corneal injuries can include, antibiotic eye drops or ointment. Steroid or non-steroidal anti-inflammatory drops may help reduce inflammation and reduce potential scarring. There are also drops that can be placed in the eye to help reduce eye muscle spasm and thereby reduce discomfort. Patching has not been shown to be effective in healing the eye and probably will not be done for most uncomplicated cornea injuries

Injuries that affect only the surface of the cornea usually heals within a few days, however severe corneal injuries may require extensive surgery or a cornea transplant.

Preventing injuries from happening is always the best course of action. Wear safety goggles and or power tools or chemicals, during high impact sports, or in other situations where there is a potential for eye injury. Wear sunglasses when exposed to ultraviolet light and sunlight even during the winter. Be careful when using household cleaners. Bleach, drain cleaners and oven cleaners are particularly dangerous and can lead to blindness if splash into the eye.

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