Eyes & Vision

Corneal Abrasion

A corneal abrasion is a traumatic defect of the corneal epithelium causing severe pain, watering and photophobia; confirm it with fluorescein, exclude a foreign body or open-globe injury, and treat contact-lens-associated abrasions as higher-risk for microbial keratitis.

Definition

A corneal abrasion is a traumatic defect of the corneal epithelium without primary stromal involvement. It causes pain, watering and photophobia and is identified by fluorescein staining; deeper, contaminated, central or infected injuries can scar or threaten vision.

First principles

A small epithelial defect can be intensely painful

The cornea is densely supplied by trigeminal sensory fibres. Removing epithelium exposes the superficial nerve endings and produces pain, foreign-body sensation, reflex tearing, blepharospasm and photophobia that may seem disproportionate to the visible scratch.

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