Corneal abrasions are one of the most frequent eye injuries kids get. They happen when something, like sand or dirt, gets into the eye. Though sometimes painful, corneal abrasions usually aren't serious and most heal within a few days. Long-term vision is rarely affected.

About Corneal Abrasions

The eyeball sits inside what's called the orbital bone. The orbital bone protects the inner part of the eye, but it can't protect the part that faces out. This part is covered by a clear, transparent tissue called the cornea. The cornea helps the eye focus and protects other parts of the eye, like the iris (the colored part) and the pupil (the black part that constricts in response to light). A corneal abrasion occurs when something scratches, cuts, or brushes up against the cornea.

Corneal abrasions can be painful, but usually heal quickly and don't cause any lingering problems. In rare cases, corneal abrasions can become infected and lead to a serious condition called a corneal ulcer. That's why it's important to have a doctor examine your child's eye if you think he or she might have a corneal abrasion.

Causes

The eye has other defenses besides the orbital bone. Eyelids and eyelashes work to keep foreign particles out of eyes. When particles get through and land on the cornea, tears help to wash the particles away. Sometimes, though, a foreign object contacts the cornea in such a way that it scratches, cuts, or damages the surface.

Things that can damage the cornea include dust, sand, wood shavings, hay, sparks, bugs, pieces of paper, and even fingernails. The cornea also can be damaged by chemical irritants, improper use of contact lenses, bright lights, and reactions to things like contact lens solutions and eye makeup.

Symptoms

Because they affect the way the cornea functions, corneal abrasions can cause problems with vision. Your child might complain of stinging or burning in the eye, of not being able to see as well as usual, or of things appearing blurry.

Other symptoms can include:

• sensitivity to light
• red or bloodshot eyes
• swollen eyelids
• a watery eye and increased tears
• the feeling of something being in the eye (foreign-body sensation)

Diagnosis

If your child has any symptoms of a corneal abrasion, call a doctor. Corneal abrasions are rarely serious, but they should be examined. The doctor can determine the extent of the abrasion and prescribe eye drops to help the healing process.

To diagnose a corneal abrasion, a doctor will examine the eye and ask questions about the symptoms and what caused the abrasion. It's possible your child won't know exactly what caused the abrasion, but probably will remember when it happened.

In some cases, the doctor will confirm a diagnosis of corneal abrasion by doing a test on the eye. A fluid called fluorescein is placed on the surface of the eye, then the doctor looks at the eye under a filtered light. Under the light, the fluorescein causes any abrasion to glow a bright green color so that it's clearly visible.

Other tests the doctor might perform include a standard ophthalmic exam and a slit lamp examination of the eye. These tests are done to check the eye's vision and functioning.

Treatment

If your child has a corneal abrasion, you'll want to have a doctor look at it as soon as possible. In the meantime, take these steps and precautions:

• Rinse your child's eye with clean water or a saline solution, or use an eye-rinse station if one is available. Rinsing the eye will help to wash away whatever is irritating the eye.
• Instruct your child to blink several times or pull the upper eyelid over the lower one. The lower eyelash may be able to brush away something stuck to the underside of the upper eyelid. Pulling on the eyelid also will make the eye produce tears, which can help wash away foreign objects.
• If there is something stuck in your child's eye, don't try to remove it. This can cause further damage to the cornea.
• Tell your child not to rub the eye, and don't touch the eye with anything like a cotton swab or tweezers. This can make a corneal abrasion worse.

After examining your child's eye, the doctor might recommend treatments to help the eye heal more quickly. The doctor also can safely remove any foreign object stuck in the eye.

To treat a corneal abrasion, your doctor may recommend prescription eye drops or an ointment. If your child's eye hurts, the doctor may suggest pain medications. If your child normally wears contact lenses, the doctor may instruct your child not to wear the lenses for a few days.

If the corneal abrasion doesn't heal within a few days or the symptoms get worse following treatment, let the doctor know right away.

Prevention

To help prevent corneal abrasions, make sure your kids wear eye protection, such as safety goggles or a facemask, whenever they work with tools, handle chemicals, or participate in sports where an eye could be affected. This includes sports like racquetball, skiing, snowboarding, hockey, and lacrosse.

When they go outside on a sunny day, kids should wear sunglasses designed to block out ultraviolet rays, especially in bright places like beaches and ski slopes. If you have pets around the house, make sure your kids are careful when playing with them. Cats, dogs, and other animals can act in unpredictable ways and scratch an eye without meaning to.

If your child wears contact lenses, make sure they fit properly and are used as directed. Keeping fingernails neatly trimmed can help prevent accidental scratches when putting in or removing contacts.

Around the house, be extra careful when anyone uses cleaning products, especially drain openers and oven cleaners. Many cleaning products contain harsh chemicals that can burn eyes. And if you have plants around your yard that someone could walk into, trim away any branches at eye level.

Reviewed by: Jonathan H. Salvin, MD
Date reviewed: June 2012