Buzz
Experts concur that various foreign substances such as contact lenses, fingernails, dust, dirt, sand, wood particles, and metal fragments can cause scratches on your cornea. Your cornea serves as the transparent protective barrier covering the front of your eye. Symptoms of a scratched cornea encompass irritation, excessive tearing, redness, light sensitivity, and the sensation of a foreign object in your eye. Studies indicate that a scratched cornea may show improvement within 24 to 48 hours with proper treatment, although symptoms may persist longer for deeper scratches. If you suspect a scratched cornea, it is advisable to consult your eye doctor to determine if medical intervention is necessary.
Procedures
Removing Objects from the Eye
Attempt blinking. Occasionally, corneal scratches result from small objects becoming lodged under the eyelid, such as dust, dirt, sand, or even an eyelash. Before addressing the scratch, it is essential to remove these foreign objects. Blinking repeatedly can help dislodge the object. Opening and closing the eye can prompt the lacrimal glands to produce more tears, flushing the foreign body from the eye.
- Using your right hand, pull the upper eyelid over the lower eyelid of the affected eye. The lower eyelid's lashes may dislodge the foreign object from the eye.
- Avoid attempting to remove trapped items with your fingers, tweezers, or any other objects, as this may exacerbate the eye injury.
Flush your eye with water. If blinking fails to dislodge the foreign object from your eye, try flushing it with water or saline solution. It's important to use a sterile or saline solution, avoiding tap water. An ideal eyewash solution should have a neutral pH of 7.0 and a temperature between 60°F and 100°F (15.5 to 37.8°C). It's commonly suggested, but do NOT pour the solution into your eye using a cup, as this can further embed the object. Follow these guidelines for rinsing your eye:
- For mildly irritating chemicals, rinse for five minutes.
- For moderate-to-severe irritants, rinse for at least 20 minutes.
- For non-penetrating corrosives such as acids, rinse for 20 minutes.
- For penetrating corrosives such as alkalis, rinse for at least 60 minutes.
- Take note of additional symptoms indicating exposure to a toxic substance, including nausea or vomiting, headaches or lightheadedness, double vision or impaired vision, dizziness or loss of consciousness, and rashes or fever. If you experience these symptoms, call poison control (800) 222-1222 and seek immediate medical attention.
Utilize eye drops. Another method to remove trapped objects is to use lubricating eye drops to flush out the injured eye. Lubricating eye drops are available over-the-counter at pharmacies. You can administer the eye drops yourself or ask for assistance. Here's how to properly use eye drops:
- Artificial tear drops are designed to lubricate and moisturize the outer surface of the eyes. They are available over-the-counter in various brands. Some contain preservatives to prolong their effects, but excessive use (more than four times a day) can irritate the eyes. If you need frequent use, opt for preservative-free artificial tears.
- Hydroxypropyl methylcellulose and carboxymethylcellulose are common lubricants found in many over-the-counter tear solutions.
- Finding the right brand of artificial tears may require trial and error, and sometimes a combination of brands is necessary. In cases of chronic dry eyes, artificial tears should be used regularly, even if symptoms are absent. However, artificial tears only provide supplementary care and cannot replace natural tears.
Consult your doctor if the scratch worsens or fails to heal. While minor corneal scratches typically heal on their own within a few days after the foreign object is removed, more severe scratches or infections may require antibacterial eye drops for proper healing. Seek medical attention if any of the following occur:
- You suspect the foreign object remains in your eye.
- You experience symptoms such as blurry vision, redness, severe pain, excessive tearing, or heightened sensitivity to light.
- You suspect a corneal ulcer (open wound on the cornea) caused by an eye infection.
- You observe green, yellow, or bloody discharge from the eye.
- You notice flashes of light or tiny dark objects floating in your field of vision.
- You have a fever.
Allowing Your Eye to Heal
Seek a diagnosis. If you suspect a corneal injury, schedule an appointment with an eye specialist. The specialist will examine your eye using a penlight or ophthalmoscope to detect any trauma. Special eye drops containing Fluorescein dye may be used to make abrasions more visible under blue light:
- A topical anesthetic is applied to your eye, followed by gentle pulling down of your lower lid. A Fluorescein strip is then touched to your eye, spreading dye as you blink. Yellow areas indicate damaged corneal regions. A special cobalt blue light is used to highlight abrasions and identify their cause.
- Vertical abrasions may indicate foreign bodies, while branching stains suggest herpes keratitis. Punctuated lesions may indicate contact lens-related issues.
- Your vision may be temporarily affected by the dye, causing a yellow tint and possibly a yellow discharge from your nose.
Take oral pain relief for discomfort. If a scratched cornea is causing pain, consider taking over-the-counter pain relief medication, such as those containing acetaminophen (Tylenol).
- Addressing pain is crucial as it can hinder the body's healing process.
- Always adhere to the dosage instructions on the packaging and avoid exceeding the recommended amount.
Avoid using an eye patch. While eye patches were traditionally employed to aid corneal scratch healing, recent medical research suggests they may exacerbate pain and prolong recovery. Eye patches impede natural blinking, straining eyelids and causing discomfort. They also increase eye tearing, inviting infection and delaying healing.
- An eye patch also reduces oxygen supply, crucial for corneal healing.
Explore alternatives to eye patches. Instead of eye patches, doctors nowadays often recommend nonsteroidal anti-inflammatory (NSAID) eye drops, combined with a soft, disposable contact lens. These drops reduce corneal sensitivity, while the lens acts as a protective barrier, expediting healing and minimizing pain. Unlike eye patches, this approach allows vision from both eyes and reduces inflammation.
- Topical NSAIDs: Consider Diclofenac (Voltaren), 0.1% solution. Apply one drop to the eye four times daily. Also, Ketorolac (Acular), 0.5% solution. Administer one drop four times daily. Refer to Part 3 for eye drop administration. Always follow dosage instructions on the packaging.
- Topical antibiotics: Options include Bacitracin (AK-Tracin), applying a 1/2-inch ribbon two to four times daily. Or erythromycin ophthalmic ointment, with a 1/2-inch ribbon application. You can also use Chloramphenicol (Chloroptic), 1% ointment, administering two drops every three hours. Alternatively, try Ciprofloxacin (Ciloxan), 0.3% solution, with varying dosages. Follow packaging instructions for dosage.
Avoid applying eye makeup. Mascara, eye shadow, or eyeliner can irritate an injured eye and impede healing. It's advisable to refrain from using eye makeup until the scratch has fully healed.
Wear sunglasses. Protect your eyes from light sensitivity caused by a scratched cornea by wearing sunglasses. Even indoors, sunglasses with UV protection can shield your eyes from excessive light.
- If light sensitivity is severe or accompanied by eyelid spasms, your ophthalmologist may prescribe eye drops to dilate your pupils. This eases discomfort and relaxes eye muscles. See Part 3 for administering pupil-dilating eye drops.
Avoid wearing contact lenses. Refrain from using contact lenses until cleared by your doctor. If you regularly wear contacts, it's advised to abstain for at least a week post-injury to ensure complete corneal healing.
- This precaution is especially crucial if the scratch resulted from contact lens wear.
- Avoid wearing contacts while undergoing antibiotic treatment for your injured cornea. Wait 24 hours after completing antibiotics before resuming contact lens use.
Using Eye Drops
Cleanse your hands. Wash your hands thoroughly with antibacterial soap before applying eye drops. Preventing bacterial introduction to the injured eye is essential to avoid potential infection.
Prepare the eye drop bottle. Upon opening, discard the initial drop. This prevents any potential contaminants or residue on the dropper from contacting the eye.
Lean back and position a tissue under your injured eye. The tissue will absorb any excess liquid from the eye. Tilting your head back facilitates gravity's assistance in allowing the drop to be absorbed into the eye, rather than simply dripping out.
- You can administer eye drops while standing, sitting, or lying down, ensuring your head is tilted back.
Administer the eye drops. Look upward and use the index finger of your non-dominant hand to pull down the lower eyelid of your affected eye. Apply the eye drops into the lower lid.
- Follow the instructions on the bottle or your doctor's advice regarding the number of drops. Avoid exceeding the recommended dosage.
- If multiple drops are required, wait a few minutes between applications to ensure proper absorption without washout.
- Avoid direct contact between the dropper tip and your eyeball, eyelid, or eyelash to prevent introducing foreign bacteria.
Close your eye gently. After applying the drops, softly close your eye and keep it shut for 30 seconds to two minutes. This allows the solution to spread over the eyelid and prevents leakage.
- Avoid squeezing the eye tightly, as it may force out the solution and cause further discomfort.
Blot around the eye. Use a soft cloth or tissue to delicately blot around the eye and remove any excess solution.
Preventing Corneal Scratches
Use protective eyewear for specific activities. Once you've experienced a corneal scratch, taking preventive measures becomes crucial. Wearing protective goggles (or glasses) during certain activities significantly reduces the risk of eye injuries.
- Sports like softball, paintball, lacrosse, hockey, and racquetball.
- Handling chemicals, power tools, or materials prone to splashing into the eyes.
- Lawn mowing and weed-whacking.
- Driving a convertible, motorcycle, or bicycle.
Avoid prolonged use of contact lenses. Prolonged wearing of contact lenses can lead to dry eyes, increasing the risk of injury. Follow your ophthalmologist's recommendations regarding wearing duration.
- Plan your day to minimize contact lens wear. For instance, if you exercise in the morning and plan an evening bike ride, switch to glasses in between activities, especially when using a computer. Ensure you have your glasses with you and switch when necessary.
Utilize artificial tears for eye lubrication. Even after your scratch has healed, use artificial tears to keep your eyes lubricated. This not only moisturizes your eyes but also helps remove foreign particles (like eyelashes) before they cause corneal scratches.
Tips
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Keep in mind that minor scratches are common and typically heal within one to two days.
Warnings
- A deeper scratch may necessitate professional intervention and could result in corneal scarring, leading to permanent vision impairment. In severe cases, a corneal transplant may be required.
