Corneal Abrasions

Private Eye Care in London
by Consultant Laura Crawley

Corneal Abrasions

Description and Symptoms

A Corneal Abrasion is a scratch on the surface of the eye. The transparent window at the front of the eye is the cornea. It consists of several layers. The outermost layer is the epithelium. This layer protects the cornea from bacteria and is the first point at which light is focused in the eye. The corneal nerves lie just beneath the epithelium, and these are sensitive nerve endings.

It is possible that the surface epithelial layer is disturbed as in a corneal scratch or abrasion. Then the exposed nerve endings make you feel like there is glass or grit in the eye and it is painful.

PATIENT STORIES

What Patients Say About Laura Crawley

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I had the best experience working with Dr Crawley. I felt looked after and she took the time to get to know me. I would highly recommend her.

Sven K. | Brighton

From the moment I met her to the moment I left, I was treated with great courtesy and kindness, and everything was explained to me in layman’s terms so I could fully understand my condition. I was immensely impressed.

Paul | London

“Thank you very much for seeing me yesterday, you were marvellous and a pride to the NHS”

Mariah P. | London

Dear Laura,
Just a quick note to say thanks for looking after my mum Mrs M. so wonderfully. It was so good of you to take so much time and care as she was very worried about my appointment and you really made such a difference to my experience. Thank you.

Ruth S. | Oxford

Dear Angela and Laura,
Thank you very much for seeing me yesterday. You were both marvellous and a pride to the NHS. You could, if you two wish, send this to your line manager. Thank you again!

Rebecca K. | Brighton

Dear Laura,
Enjoy your holiday and thanks for everything so far.
Best Wishes

Janet A. | London

Causes of Corneal Abrasions

Corneal abrasions are typically caused by dust or grit blowing into the eye on a windy day. Also causes are a fingernail scratch from children or by anything that hits the surface. Most of the time these causes of the eye damage happens usually by accident.

Diagnosis and Examination

Ms. Crawley will see a corneal abrasion using the blue light on the slit lamp microscope. Bright orange fluorescein dye drops are put into your eye. These are often mixed with local anaesthetic to numb the eye to allow a proper examination. The fluorescein dye highlights the scratch when cobalt blue light from the microscope is shown on it. This is a painless test.

Treatment

The scratch will heal within 2-3 days. Antibiotic ointment or drops are used to protect the cornea from bacteria that may use the scratch as an opportunity to cause infection. Occasionally a pad is put on the eye for a few hours. This is not necessary for all patients but can be helpful to protect the eye when travelling home from the clinic. Regular painkillers will help to reduce the gritty discomfort. The scratch will heal completely in uncomplicated cases and will be invisible at the next eye examination.

FAQs

Can i have some local anaesthetic drops to take home?

Local Anaesthetic drops numb the eye and make the eye more comfortable to allow a good examination however they are not helpful to take home as a painkiller. The eyedrops increase the healing time of the abrasion meaning that the risk of infection can be significantly higher turning a simple scratch into an ulcer that can threaten the vision.

I had a scratch some months ago that healed but when i wake up in the morning it feels like it has come back

This is known as Recurrent Corneal Erosion Syndrome.

This occurs when the new layer of epithelial cells close the scratch but do not put down good roots to fix the new layer onto the surface of the eye. Overnight the surface of the eye dries out to a degree when we are asleep meaning that the eyelids can disturb this new layer on waking re-opening the abrasion or scratch. This re-opening is usually small, so the symptoms subside by lunchtime but then recur the next day.

Recurrent corneal erosions can be managed with a thick lubricating ointment, such as Lacri-lube, instilled at night before sleeping to reduce the risk of the new epithelial cells being disturbed. It may be necessary to use lubricants for three months to allow the new cells to embed fully.