Alamo Optometry Blog

July 13, 2011

Corneal Abrasions

Filed under: Uncategorized — gkblog @ 8:08 pm

Corneal Abrasions

 (As appeared in Alamo Today, July 2011, pg. 24)

            Since we had a case of a rather large corneal abrasion last week, I decided it should be the topic of the month.  These conditions are very painful and can lead to vision loss if not treated quickly and appropriately.

            To fully understand corneal abrasions, we must first discuss and understand the cornea.  The cornea is the clear front part of the eye, and it does about 2/3 of the focusing of light in the eye (the lens does the other 1/3).  It is made of clear collagen, and it actually derived from the same tissue that makes up the white part of the eye (sclera).  The cornea contains no blood vessels and it receives all of its oxygen requirements from the air and tears.  The cornea is made up of 5 layers, and it regenerates itself in about 1 week.  Lastly, if you wear contact lenses, you place your contacts on top of the cornea, and it is also the tissue that is operated on in LASIK and PRK.

            Now the good and bad about the cornea; like I mentioned above it does regenerate itself in about a week and it heals itself relatively quickly after an infection or abrasion.  The flip side is that it is one of the most highly innervated tissues with nerves in the body.  This means that it is extremely sensitive to any insult.  For those of you that have battled a corneal infection or abrasion, you can attest to the pain that is involved in these cases.  So the bad thing is that you will be in severe discomfort for a few days, but with the correct treatment, the healing time will not be that long.

            It is actually pretty easy to diagnose a corneal abrasion.  When these patients come into the office, their eye is extremely red, is tearing excessively, they have on dark sunglasses because of the light sensitivity, and are in pain.  The vision is usually decreased, but not excessively considering the condition of the eye.  I will put a yellow dye in the eye which will allow me to fully see the extent of the abrasion and to measure it.  I will also look for foreign bodies in the eye (mostly under the top lid), and remove them as these get trapped under the lid and then every time you blink they continue to scratch and injure the eye.  I will also give a drop of anesthetic in the eye which will immediately make the patient feel better as it will numb the cornea.  After this drop, most patients ask if they can just take that bottle home with them.  As much as I would like to, the anesthetic actually slows down the healing process of the cornea.  So you would feel comfortable, but your cornea would turn to mush as the regeneration process would be halted.

            After the diagnosis is made, I will usually apply a bandage contact lens to the eye.  The contact lens acts as a band-aid on the eye; now every time you blink, instead of further irritating the abrasion, you now blink on the contact lens.  For those who normally don’t wear contacts, the slight irritation from the lens is far less than the pain from the abrasion.  This also allows the cornea to heal quicker.  I will also give the patient an antibiotic to help protect against an infection.  Now that there is an opening in the cornea, it is very easy to for an infection to start.

            The only good thing about these abrasions is that the patient is usually in so much pain that they do not wait very long before getting help.  As long as the trauma that caused the abrasion did not fully penetrate the eye (very rare), the cornea usually heals within a few days, and you are back to normal in under a week.  Hopefully this never happens to you, but we look forward to helping you if it does.

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