By Martha A. Simpson, D.O., M.B.A.
Assistant Professor of Family Medicine
Ohio University College of Osteopathic Medicine

SERIOUS CORNEAL ABRASIONS REQUIRE DOCTOR’S CARE

QUESTION: Yesterday, I think I scratched my cornea.  I wear contacts, and they had been in for 18 hours, so my eyes were getting a little irritated.  I rubbed them really hard (with the contacts in) and then took the contacts out after that.  All day today, my right eye has been hurting, like the contact is still in it.  Did I injure my cornea?

Answer: Yes, it does sounds like you may have scratched your cornea. This is a relatively common occurrence. The good news is that scratches to the cornea generally heal up very quickly and without complication. The bad news is that they can be quite painful.

Although you’ve personally been experiencing this pain and may feel as though you know more than you want to know about your cornea, for the rest of us here is a bit more about corneal abrasions. The cornea is the clear, curved structure on the front of the eye. Its primary job is to help focus our vision. It provides over 60 percent of the focusing power in the eye —- the lens does the rest. The cornea is a five-layered structure that is very tough, but it can be prone to injury.

If you get poked in the eye or “get something” in your eye, the cornea can get scratched. The cornea can also be damaged by extensive exposure to ultraviolet light, such as can happen when you use a tanning bed or engage in welding. Generally, in the first few hours after an injury to the cornea, the eye becomes painful and light sensitive. The eye may water and feel like it has something in it. Most people go the doctor for this since it is so uncomfortable.

The doctor will examine the eye, usually with some dye and a Wood’s Lamp (black light). The scratch or abrasion will glow green under the dye. The physician may also use a special lamp, called a slit-lamp to examine the eye. He or she will also be sure there are no foreign bodies in the eye or imbedded in the cornea.

Once the exam is complete, your eye may be treated with dilating drops to stop eye muscle spasms and some antibiotic drops or ointment. Sometimes your eye will be patched. Over-the-counter pain pills may not be adequate in some cases, so your doctor may prescribe stronger pain medication. Your physician should recheck your eye in 24 to 48 hours. There can be complications from corneal abrasions, but these are rarely seen following small, uncomplicated abrasions -- like the one you’re apparently experiencing.

However, if your pain does not go away in another day, you should see your family physician for an examination. Depending on the extent of your abrasion and how quickly it heals, you may or may not have to be referred to an eye specialist known as an ophthalmologist.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701. Past columns are available online at http://www.FamilyMedicineNews.org.