Corneal Abrasions

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Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh
Dr S.S. Gill

Eye Health

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. GILL talking to us about CORNEAL ABRASIONS.

A corneal abrasion is a scratch injury to the cornea. The cornea is the clear dome-shaped transparent, outermost part of the eye. You can liken this part of the eye to the windscreen of your car. Injuries to this part of the eye occur commonly in both kids and adults. It usually occurs when some sand or dust enters the eye.

What are the causes?

The eye has natural barriers like the eyelashes to prevent particles or foreign bodies from entering the eyes. When a foreign particle enters the eye, the eye responds by producing a flood of tears to try and wash away the foreign particles.

The problem comes about when the foreign object remains in the eye and is in contact with the cornea in such a way that it scratches, cuts, or damages the surface. This is made worse when the person rubs the eye in an effort to get it out – which most often happens in kids! You can envision this simple action of rubbing the eye to have an effect of sandpaper on the cornea because of the trapped particle underneath the eyelid rubbing against the surface of the cornea.

Many things can enter the eye to damage or scratch the cornea. These include sand particles, dust, ceiling board flakes, wood shavings, insects, sparks from a fire, cooking oil pieces of paper or the edge of a sheet of paper and even a person’s own fingernails! Other things that may damage the cornea are chemicals, poor handling of contact lenses and eye make-up or facial cleansers used when a woman goes for a facial treatment.

Symptoms

Firstly, this will almost certainly be painful. Secondly, because of the way in which the cornea functions, it often causes vision disturbances. Often there will be a stinging or burning in the eye along with blurry vision in the affected eye.

Some of the other symptoms include the following:

  • Photophobia: the eye is hypersensitive to light.
  • Hyperaemia: the eye is bloodshot or red.
  • Lacrimation: tearing or watering from the eye is usually excessive and persistent.
  • Foreign body sensation in the eye: a sensation of a something stuck in the eye.
  • Eyelid oedema: swelling of the eyelids may occur.

How is it diagnosed?

Well, the history of something getting into the eye is quite classical. Should you or your child be exposed to something like this, DO NOT RUB THE EYE but flush the eye out with tap water or sterile normal saline if you have some of this at home. It is best to seek professional help if you are unsure of whether or not the foreign particle has come out of the eye or not, more so if you still have symptoms.

Ophthalmologist Dr S.S. Gill
Corneal Abrasions

Your GP will look for any particles still present in the affected eye. Often, the doctor will flush out the eye with normal saline solution in an attempt to flush minute particles that may not be so easily visible with a torchlight examination. If the cornea is extensively abraded, often the GP will refer the patient to the eye doctor.

The eye doctor will be able to determine if the particle is still there and also determine the extent of the corneal abrasion. Often, the eye doctor will confirm the presence of the corneal abrasion by instilling a special stain called fluorescein into the eye. Then, using cobalt blue filtered light, any corneal abrasion will light up a bright green fluorescent colour – to reveal the extent of the corneal abrasion. (See adjacent picture)

How serious is this?

Corneal abrasions if treated properly heal completely and do not cause any trouble. Corneal abrasions only cause trouble if they get secondarily infected and end up as corneal ulcerations that may even lead to blindness. Rarely, corneal abrasions do not heal well and the layer of epithelium (outer layer of cornea) refuses to close up permanently, resulting in frequent breakdown known as persistent corneal epithelial defects. Should you suffer from any symptoms that are prolonged, do seek professional eye treatment.

For more information, call Gill Eye Specialist Centre at Hospital Fatimah (05-545 5582) or email gilleyecentre@dr.com.