Corneal Abrasion: Symptoms, Complications, and Treatment Guide

A corneal abrasion is a scratch on the cornea, the clear protective outer layer of the eye. While often minor, these injuries require prompt evaluation to prevent vision-threatening complications.

Immediate Symptoms

• Sharp, burning, or gritty pain – often disproportionate to injury size
• Excessive tearing (epiphora)
• Blurred or distorted vision
• Photophobia (light sensitivity)
• Foreign body sensation – feeling something is "in the eye"
• Conjunctival injection (redness)
• Blepharospasm (involuntary eyelid closure)

Potential Complications

• Bacterial keratitis / corneal ulcer: Infection risk increases with contact lens use, organic matter (plant material), or delayed treatment.
• Recurrent corneal erosion: Poor adhesion of healed epithelium causes spontaneous reopening, often upon waking.
• Corneal scarring: Deep abrasions may heal with opacity, impairing vision.
• Secondary glaucoma or uveitis: Inflammatory sequelae.

Immediate Management

1. Do not rub the eye. This worsens the defect.
2. Rinse with sterile saline or clean water if chemical or particulate exposure.
3. Seek urgent ophthalmic evaluation – same-day if possible. Urgent care or ER if after hours.
4. Protect the eye with a rigid shield (not a pressure patch, which can promote infection).

Medical Treatment

• Topical antibiotics (e.g., fluoroquinolone drops or erythromycin ointment) – prophylactic against infection.
• Cycloplegic drops (e.g., cyclopentolate) – relieve ciliary spasm and photophobia for large abrasions.
• Oral analgesics (NSAIDs, acetaminophen) for pain.
• Bandage contact lens for large or painful defects – promotes healing and comfort.
• Follow-up within 24–48 hours until epithelial defect resolves.

Prevention

Wear protective eyewear during high-risk activities (sports, grinding, yard work). Proper contact lens hygiene and replacement schedules reduce abrasion risk from lens wear.