Corneal Abrasions and Corneal Erosions

 

What is the Cornea?

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The cornea is the clear front window of the eye. It covers the colored portion of the eye, much like a watch crystal covers the face of a watch. The cornea is com­posed of five layers. The outermost layer is called the epithelium.

 

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What is a Corneal Abrasion?

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A corneal abrasion is an injury to the surface layer of the eye (corneal epithelium). Abrasions are very painful. Com­mon causes of corneal abrasions include contact lenses use, a scratch from finger­nails, paper cuts, branches from trees/bushes, or rubbing of the eye. There are some eye conditions, such as dry eye, that may make injury more likely.

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The corneal surface usually heals within one to three days, but the eye may be extremely uncomfortable while it is healing. You may experience watering of your eye, light sensitivity, and the feeling that something is in the eye (a foreign body sensation).

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What is a Corneal Erosion?

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Corneal erosion is a spontaneous breakdown of the epithelium, sometimes at the site of an earlier abrasion.  This often occurs when the eyes are dry or irritated. The symptoms are similar to a corneal abra­sion, although can vary and often occur upon awakening.

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How is a Corneal Abrasion/ Erosion treated?

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Depending on the severity, the abrasion may be treated with ointment and an eye patch.  Instead of a patch, Dr. Varma may place a special contact lens on the cornea called a bandage contact lens.  This covers the cornea so the eyelid is not rubbing the surface of the eye when blinking.  After removing the patch/bandage contact lens, you may be asked to use ointment or artificial tears frequently and repeatedly, creating a soothing layer between the inner eyelid and the abra­sion. You may be given a prescription for an antibiotic because of the small risk of infection. Infection can be very serious and can cause permanent loss of vision.

              After the cornea has healed, it may still be sensitive to wind and dust.  It is helpful to use an artificial tear both during the day and at bedtime until the sensitivity has disappeared. Some other diseases, such as dry eyes or diabetes, may slow healing.  It is important not to rub your eye for the first 2 weeks after the abrasion has healed as this can cause it to recur.

 

What is recurrent Corneal Erosion syndrome?

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Recurrent corneal erosion syndrome is a condition where you have repeated episodes of loss of surface cells of the cornea (epithelial cells).  When lost or pulled off by the movement of the eyelid, this leaves a bare spot on the cornea. The most common cause is the weakness of the epithelial cells at the site of a previous abrasion.  Other causes include inherited corneal conditions or severe dry eyes. 

                    The best treatment is the diligent use of artificial tears/ointment to lubricate the cornea.  You may be asked to use Muro 128, an eyedrop or ointment which decreases the frequency of recurrent erosions. If the epithelium does not heal properly you may require micro-puncture of the epithelium or epithelial debridement where the epithelium is removed to allow it to re-grow. 

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