One of the most painful eye conditions also happens to be one of the most common, especially during the holiday season. From basting turkeys, to putting up Christmas lights, the holidays are full of activities we don’t regularly do, which can lead to some interesting eye injuries. One of the most common eye injuries this time of year is the corneal abrasion. The cornea is the clear front window of the eye, and it is the most sensitive part of the body, with 400 times the nerve density of our skin. This means that a scratch on the cornea hurts 400 times worse than a scratch on your skin!
The cornea has 3 main layers. The top layer, called the epithelium, the middle layer or stroma, and the back layer, the endothelium. The epithelium is the structure that is damaged by a scratch or “abrasion”. When the epithelium is scratched, it exposes all of those tiny nerves which causes intense pain. A corneal abrasion will be immediately obvious to the person, making the eye red, light sensitive, and very resistant to opening.
A corneal abrasion is a condition that should be evaluated and managed by a doctor. Often people will first present to an urgent care or emergency department. However, injuries of the eye are best handled by either an optometrist or ophthalmologist. An eye doctor will usually numb the eye and use a stain to better visualize the corneal damage. Standard of care for an abrasion of the cornea involves antibiotics, lubrication, and depending on the amount of damage, a contact lens to act as a bandage. Some antibiotics for corneal abrasions include drops like Polytrim and Besivance. Antibiotic ointments such as Erythromycin are also commonly used due to their ability to better lubricate the eye, while also providing the antibiotic effect. These drops are typically dosed 4 times per day for a week or more depending on the amount of damage. These drops help to fight and/or prevent infection while the cornea heals. Fortunately, the cornea heals quickly and usually without scarring, so a minor abrasion of the cornea rarely results in any permanent visual consequence.
Ways to avoid corneal abrasions are careful consideration of your activities, and the use of protective eyewear. Low profile safety glasses can be purchased at your local hardware store, and can go a long way in protecting your eyes. I recommend people wear safety glasses in any condition where an object or chemical may contact the eye such as yardwork, sports, and cleaning. If you or someone you know may be suffering from a corneal abrasion, it is important to get them to a doctor as soon as possible. For more information, talk to your doctor and/or see the links below.