Scratched Cornea Treatment: What to Do for a Corneal Abrasion

What is a Corneal Abrasion?

A corneal abrasion is a scrape or scratch affecting the cornea, the transparent tissue covering the front of the eye. The cornea helps shield the structures inside the eye and plays an important role in focusing light, which means even a small injury can cause significant discomfort or temporary changes in vision.  

A corneal scratch can happen when a fingernail, tree branch, makeup brush, contact lens, or small piece of dust, sand, dirt, metal, or wood comes into contact with the eye. Rubbing the eye when a particle is trapped beneath the eyelid can also scrape the corneal surface. 

The cornea contains many sensitive nerve endings, so even a shallow abrasion may be quite painful. Symptoms may include redness, watering, light sensitivity, blurry vision, or a gritty sensation that makes it feel as though something remains in the eye. If pain is severe, vision changes, or symptoms do not begin to improve, an eye doctor can examine the injury and determine whether additional treatment is necessary.

How Can You Tell If You Scratched Your Cornea?

A corneal abrasion often produces noticeable symptoms shortly after the injury occurs. Many people describe it as feeling like a grain of sand or another small object is trapped beneath the eyelid. Blinking may make the irritation more noticeable, and the eye may sting, burn, or become difficult to keep open. 

Possible signs of a scratched cornea include:

• Eye pain or stinging 

• Redness 

• Excessive tearing or watery eyes 

• Sensitivity to light 

• Blurry or hazy vision 

• A gritty or foreign-body sensation 

• Difficulty keeping the affected eye open 

Symptoms may be more or less intense depending on the size, depth, and location of the abrasion. Significant vision changes, worsening redness, severe pain, or symptoms that continue to intensify should be evaluated by an eye care professional.

What Should You Do Right After Scratching Your Eye?

If you believe you have scratched your eye, avoid rubbing, pressing, or repeatedly touching it. Rubbing can make irritation worse and may cause additional damage, particularly if sand, dust, or another particle is still beneath the eyelid. 

Gently rinse the eye with sterile saline or clean water to help wash away loose debris. Blinking several times may also allow your natural tears to flush out small particles. If you wear contact lenses, remove them and leave them out until the eye has healed and your eye doctor confirms that it is safe to begin wearing them again. 

Do not use tweezers, cotton swabs, fingernails, or other objects to remove anything that appears stuck to or embedded in the eye. Avoid using leftover prescription drops or medication prescribed for another person as well. If the object cannot be rinsed away, your vision is affected, pain is significant, or symptoms fail to improve, contact an eye care professional.

How is a Corneal Abrasion Treated?

Treatment depends on how the eye was scratched, the size and location of the abrasion, whether foreign material remains in the eye, and whether there are signs of infection or a deeper injury. Contact lens wear is also important because certain corneal infections occur more frequently in people who wear contacts.   

For an uncomplicated abrasion, treatment generally focuses on keeping the eye comfortable, reducing the risk of infection, and allowing the damaged corneal surface to heal. An eye doctor can examine the injury and determine which treatments are appropriate for your situation.

Removing Debris from the Eye

When an abrasion is caused by dust, dirt, or another loose particle, removing the material may be the first step in treatment. Some debris can be rinsed away with clean water or sterile saline. If a particle remains beneath the eyelid or attached to the corneal surface, an eye care professional can use magnification and appropriate instruments to remove it safely. 

Do not try to remove anything that appears embedded in the eye. Injuries involving metal fragments, power tools, high-speed particles, wood, or other objects that may have penetrated the eye require prompt professional care. 

Antibiotic Eye Drops or Ointment

An eye doctor may prescribe an antibiotic eye drop or ointment while the cornea heals. These medications can help lower the risk of infection after the protective surface of the eye has been damaged. 

The antibiotic used may depend on the cause of the injury and whether you wear contact lenses. Abrasions associated with contact lens use require additional caution because contact wearers have a greater risk of certain types of corneal infection. If your eye was scratched while you were wearing contacts, remove the lenses and do not put them back in until your eye doctor says it is safe. 

Lubricating Eye Drops Ointments

Artificial tears, lubricating drops, or ointments may help reduce friction and keep the eye more comfortable during the healing process. Adding moisture to the eye surface can soothe dryness and irritation while the damaged cells repair themselves. 

Not every eye drop is appropriate for an injured cornea. Avoid using old prescriptions, another person's medication, or products that have not been recommended for your injury. Your eye doctor can tell you which lubricating products are suitable. 

Managing Eye Pain

Corneal abrasions can be painful because the cornea has a dense supply of nerve endings. Depending on the severity of your symptoms, your eye doctor may recommend an appropriate form of pain relief while healing takes place. 

A clinician may use anesthetic eye drops during an examination to numb the eye temporarily. These drops are generally not intended for unsupervised home use. Repeated or improper use of topical anesthetics can delay healing and potentially cause serious corneal damage. 

Prescription Dilating Drops

For certain larger or more painful abrasions, an eye doctor may use drops that temporarily enlarge the pupil. These medications can help relax muscles inside the eye and reduce spasms that may contribute to pain following a corneal injury. 

  Dilating drops are not required for every scratched cornea. Your doctor will determine whether they may be helpful based on your symptoms and examination findings.

Bandage Contact Lenses

In some cases, a special bandage contact lens may be placed over the injured cornea. Unlike a regular contact lens used to correct eyesight, a bandage lens serves as a protective covering for the healing eye.   

The lens can reduce friction caused by blinking and may improve comfort while damaged corneal cells recover. Because placing a contact lens over an injured eye can increase infection concerns, bandage lenses must be used under an eye doctor's supervision.   

Follow all instructions for follow-up visits and lens care. Do not substitute your normal prescription contact lenses for a medical bandage lens or resume regular contact lens wear before receiving clearance from your doctor.

When Should You See an Eye Doctor for a Corneal Abrasion?

Some small abrasions may begin improving within a relatively short period, but professional evaluation is important when symptoms are severe, persistent, or becoming worse. An eye doctor can check for infection, deeper damage, retained debris, or another condition that could be causing similar symptoms.   

Contact an eye care professional if you experience:

• Severe or worsening eye pain 

• Blurry, decreased, or otherwise changing vision 

• Increasing redness or swelling 

• Discharge from the eye 

• A persistent feeling that something is stuck in the eye 

• Symptoms that are not improving as expected 

• An injury caused by metal, wood, plant material, or high-speed debris 

• A corneal abrasion related to contact lens wear 

• An object that cannot be rinsed from the eye 

How Quickly Does a Corneal Abrasion Heal?

Small, uncomplicated corneal abrasions often begin feeling better within approximately 24 to 48 hours and may heal completely within several days. The corneal surface repairs itself efficiently, but recovery time varies based on the depth, size, location, and cause of the injury.   

Larger abrasions may take longer to heal. Recovery may also be slower when an injury is associated with an infection, contact lens wear, or foreign material that remains in the eye. Pain, tearing, and sensitivity to light should usually lessen as the surface heals, although mild irritation may continue for a short time.   

If symptoms are not improving, become worse, or return after the eye initially felt better, contact your eye doctor. Occasionally, the injured area of the cornea may not attach securely after healing and can reopen later. This is known as recurrent corneal erosion and may cause repeated episodes of pain or irritation. An eye care professional can examine the cornea and recommend additional treatment if healing is not progressing normally.