Corneal Abrasions

Corneal abrasions can present with a variety of symptoms, including eye tearing, the sensation of a foreign body in the eye, discomfort with blinking, sharp pain, and photophobia. In infants, corneal abrasions have presented as initially unexplained, inconsolable crying. Obviously, caution must be taken not to overlook a potentially more serious cause of the infant’s discomfort when attributing inconsolable crying to a small corneal abrasion. A child may be continually rubbing an eye which is watery and red. The injury that causes the corneal abrasion may be mild and usually occurs accidentally; often there is a history of the eye being scratched or hit by an object. Corneal abrasions are caused also by prolonged or inappropriate use of contact lenses.

The cornea is highly innervated, and even a small abrasion can cause pain that ranges from mild to severe, often making the child reluctant to open the injured eye because of the discomfort. Patients may have episodes of intermittent sharp pain from spasms of the ciliary body in response to the injury.

In the case of the patient who wears contact lenses, the lenses should be removed before examination of the eyes. Instillation of a topical anesthetic, such as proparacaine 0.5% or tetracaine …