Corneal Abrasion (Corneal Erosion)

A corneal abrasion, also called a corneal erosion, is a superficial scratch on the cornea, the transparent, dome-shaped layer at the front of the eye. The cornea covers the iris (the colored part) and the pupil and is one of the most sensitive tissues in the human body. Even the smallest injuries can cause severe pain.

Causes

Corneal abrasions are caused by mechanical impact on the eye surface:

Foreign bodies: sand, dust, metal splinters, or other small particles
Fingernails: a common cause, especially in infants and toddlers
Contact lenses: wearing them too long, inserting them improperly, or damaged lenses
Branches and plant parts: while playing outdoors or gardening
Dry eyes: a dry tear film makes the cornea more susceptible to injury
Rubbing the eyes: especially when foreign bodies are present on the surface

Symptoms

Severe pain: often disproportionately strong compared to the size of the injury
Foreign-body sensation: the feeling that something is stuck in the eye
Tearing: heavy watering of the affected eye
Redness of the eye
Light sensitivity
Blurred vision
Lid spasm (blepharospasm): involuntary squeezing of the eyelids

Diagnosis

The ophthalmologist examines the cornea with a slit lamp (slit-lamp microscope). To make the abrasion more visible, a fluorescent dye (fluorescein) is often used. It is applied to the eye as a drop or with a paper strip and glows green under blue light – wherever the corneal surface is damaged.

At the same time, the doctor checks whether a foreign body is lodged on the cornea or under the upper eyelid that could have caused the injury.

Treatment

Small abrasions

Superficial scratches often heal on their own within 1 to 3 days, as the cornea regenerates quickly. During this time, moisturizing eye drops (artificial tears) can relieve the discomfort.

Larger injuries

Antibiotic eye drops or ointments: prevent a bacterial infection of the open wound surface
Pain relief: painkillers (e.g. paracetamol or ibuprofen) help with stronger discomfort
Bandage lens: in some cases, a soft contact lens is applied as a bandage to protect healing and reduce pain
Pupil-dilating drops (cycloplegics): can relieve the painful lid spasm

Follow-up treatment

After healing, the ophthalmologist sometimes recommends an eye ointment before bedtime for a few weeks. This prevents the healed wound site from breaking open again (recurrent erosion), which can occur particularly in the morning when opening the eyes.

Healing time

Most corneal abrasions heal completely within 1 to 5 days. The healing speed depends on the size and depth of the injury and on the general condition of the cornea. Contact lens wearers and people with dry eyes sometimes need a little longer.

Prevention

Wear protective glasses: during manual work, when handling tools, and during certain sports
Keep fingernails short: especially in infants and toddlers
Use contact lenses properly: observe wearing times and do not continue wearing damaged lenses
Treat dry eyes: regular use of artificial tears

When to see an ophthalmologist immediately?

Seek medical help promptly if:

A foreign body is stuck in the eye and cannot be rinsed out
The pain is very severe or increasing
Vision is significantly impaired
The symptoms do not improve after 24 hours
The injury was caused by a metal splinter or a chemical substance