CORNEAL ABRASION

  One of the most common injuries of the eye is an abrasion. In this condition, the surface layer of the eye (epithelium) is removed by such dangerous intruders as baby's fingernails, tree limbs, bushes, and the like.
   Abrasions are very painful. They also cause excessive tearing,redness and blurred vision.These usually heal in a short period of time.
   Treatment consists of a patch to keep the lids from moving or an ointment or even a contact lens to protect the healing tissues. Pain relievers such as ibuprofen (eg. Advil)are used as needed for comfort. A good night's sleep is curative in most cases. Often an antibiotic is instilled because an abrasion is an invitation for infection. Abrasions covering small areas heal rapidly;those covering more than a third of the cornea may take a day or two to completely cover over again.It is important to NOT rub the eyes during the healing phase. The new cells have poor connections to the underlying tissue and can easily be rubbed off. When this occurs the pain returns and retreatment is necessary.
   In the office a local anesthetic is instilled into the eye to allow enough comfort for a reasonable examination of the injury. Repeated use of the anesthetic may cause harm to the eye and is therefore only used as an aid in making a diagnosis and NOT in the treatment of abrasions.
   Occasionally, long after an abrasion has healed it recurs spontaneously.This often happens upon awakening in the morning. This is called are current erosion and represents an area of epithelium which is not well"glued" down to the deeper parts of the cornea. The treatment is similar to that of an abrasion. Sometimes we prick the bare surface of the cornea with a needle in order to help form better connections between these two surfaces. Bedtime ointments and other forms of lubrication are also helpful in treating this troublesome complication.