Corneal Abrasion Health Article

Prognosis

Corneal abrasions usually heal within a week, but complications can occur. A secondary infection and scarring can result if the abrasion is not treated. Up to 50 percent of those with a corneal abrasion develop a uveitis or inflammation inside the eye.

Approximately 10 to 25 percent of those with corneal abrasions will develop recurrent corneal erosion (RCE) a condition in which the epithelium of the cornea pulls off because it did not heal properly or completely. This can happen weeks, months, or years after the initial trauma. Usually the patient either awakens with sharp pain or is bothered by a foreign body sensation that is worse in the morning. This erosion is usually treated conservatively with lubricating drops and hypertonic saline ointment for a month or more, although some patient need a debridement of the cornea or laser treatment. Oral doxycycline and topical steroids have been shown to help with the restructuring of the cornea with a RCE.

The probability of corneal ulcer development from a corneal abrasion increases tenfold in contact lens wearers for those who use extended wear contacts, over those who remove their contacts as night. This risk may be decreased for those wearing the new silicone contact lenses.

Prevention

Prevention of a traumatic injury or an accident is not possible, but for those types of abrasions caused by chronic trauma, such as with contact lenses, the likelihood of abrasions and subsequent ulcers can be reduced by proper contact lens wear and care. It is important that children and adolescents who wear contact lenses have glasses to wear and that glasses are worn every day to give the eyes a chance to breathe. The contact lenses should be replaced and cared for as recommended by an eye care practitioner.

For those who engage in welding, eye protection, including the use of helmets, decreases the incidence a corneal abrasions caused by welding burns.

Parental concerns

Rarely do corneal abrasion lead to loss of vision, but any trauma to the eye must be evaluated by a healthcare practitioner for the possibility of an abrasion. When an abrasion is present, then it is imperative that prescribed treatment, including cessation of contact lenses and use of prescribed drops be followed. If the corneal abrasion is due to contact lens abuse, then the consequences of further misuse of contact lenses must be thoroughly discussed with the eye care practitioner.

BOOKS

Hersch, Peter S., et al. "Anterior Segment Trauma" in Principles and Practice of Ophthalmology, edited by Daniel M. Albert, et al. Philadelphia: Saunders, 2000.

Scoper, Stephen V. "Corneal Abrasions, Lacerations, and Perforations" in Current Ocular Therapy, Vol. 5, edited by Frederick T. Fraunfelder. Philadelphia: Saunders, 2000.

PERIODICALS

Karpecki, Paul M. "The Effort to Cure Recurrent Erosions." Review of Optometry (July 15, 2002): 76–77

Michael, Jeffery G., et al. "Management of Corneal Abrasion in Children: A Randomized Clinical Trial." Annals of Emergency Medicine 40 (July 2002): 67–72.

Rittichier, Kristine K., et al. "Are Signs and Symptoms Associated with Persistent Corneal Abrasions in Children?" Archives of Pediatrics and Adolescent Medicine 154 (April 2000): 370–74.

Trad, Michael J. "Pressure Patching Indicated in Few Cases of Traumatic Corneal Abrasions." Primary Care Optometry News 9 (September 2004): 36–37.

Martha Reilly, OD