What Causes Scratched Eye (Corneal Abrasion) and How to Treat It

What is a scratched eye?

A scratched eye, also known as a corneal abrasion, is when the outermost layer of the cornea (the clear part in the front of the eye) becomes damaged or lost. This can happen from an eye injury, infection, surgery, and dryness, though trauma is the most common cause.

Often people experience sudden pain in the eye, followed by tearing and decreased vision. If you imagine that your eye is like a camera, then the cornea is like the camera’s lens. It allows you to focus light and see clearly. Therefore, a scratch on the surface can damage your vision.

It’s usually treated with prescription eye drops, but you may need to wear a special contact lens. Your doctor will also make sure there is no foreign object remaining in the eye, as prolonged contact can delay healing. Depending on the cause, a scratched eye may take anywhere from a few days to a few weeks to heal.

Children can also get corneal abrasions—siblings, pets, toys, and other inanimate objects may scratch them during play. They will generally complain of pain, may have excessive tears from the eye, and may try to keep the eye closed by squinting. In general, corneal abrasions in children will heal very quickly and often do not require prescription antibiotic drops. But their eye should be checked by a doctor.

Most common symptoms

The most common symptoms of a scratched eye are pain, decreased vision, sensitivity to light, tearing, and a feeling as if something is in the eye irritating it.

Symptoms

• Pain, often sharp and stabbing
• Mild to severe loss of vision, depending on how much of the cornea is damaged
• Redness in the white part of the eye
• Feeling like something is in the eye
• Sensitivity to light (photophobia)
• Burning
• Headaches, often in the forehead, brow, or temple around the affected eye

Causes

The cornea is the outermost layer of the eye so anything that comes into contact with it can scratch or irritate it. These may include:

• Contact lenses
• Eye makeup
• Chemicals (such as household cleaning products)
• Foreign matter (mascara wands, dust, leaves, tree branches, airborne debris, fingernails, etc.)

Medical conditions can also put the cornea at risk for extreme dryness or infection with common bacteria and viruses. Both increase the risk of a scratched cornea. Others at a greater risk of scratched eye include:

• People with diabetes and certain autoimmune conditions (such as Sjogren's syndrome)
• People at risk for viral infections, including herpes simplex virus and shingles, which are the two most common viruses that affect the eyes.
• Welders and people who perform mechanical work.

Next steps

If you think you have scratched your eye, you should seek medical attention if:

• Your symptoms last more than 12 to 24 hours.
• Your pain is uncontrollable.
• Your vision is severely impaired.

When you first injure your eye, gently rinse your eye with tap water, saline, or artificial tears. The best way to do this is to tilt your head back, pull down your lower eyelid, and gently drip tear drops or a saline flush in the eye. This should also help wash away any larger debris that may be in the eye. If you think there’s something in your eye, you can pull your upper eyelid down to help remove it.

Artificial tears are slightly different than saline solutions. They have a lubricating component, making them more comfortable on the eye. But you should not put any prescription eye drops in your eye—even if you have used them before—unless instructed by your doctor.

If you have an optometrist or ophthalmologist (eye doctor), make an appointment to be seen that day. If you don’t have an eye doctor, go to your nearest urgent care.

Treatments

Small corneal abrasions will likely heal on their own with time. Larger abrasions may need treatment with prescription antibiotic drops (to prevent an infection). Be sure to finish your prescription medication, as instructed, even if your eye has healed. Most corneal abrasions will heal quickly, from 1 to 4 days.

If you have a corneal abrasion that affects most of the cornea or is deeper than the outermost layer, your doctor will use several approaches— antibiotic drops, possibly steroid drops, and a bandage contact lens. Your doctor will need to follow you closely. These abrasions may take many weeks to heal and may leave a scar on the cornea.

If you have a non-healing or severe abrasion, be sure to keep scheduled follow-up visits with your doctor. If you have a recurring corneal abrasion or one that requires more specialized treatment, your doctor may refer you to a corneal specialist.

Preventative tips

To prevent a corneal abrasion:

• Wear protective eyewear, such as sunglasses and safety glasses.
• Keep your hands clean when touching the eye (for example, putting in contact lenses or applying makeup).