Operational Medicine 2001
Corneal Abrasion

Definition: Injury to the epithelial surface of the cornea.  

Examples:

• Finger

• Foreign body

• Contact lens

• Chemical

Symptoms:  pain, foreign body sensation, tearing, photophobia, conjunctival injection.

Signs: positive fluorescein staining of a corneal epithelial surface defect in the eye

Differential Diagnosis:  herpes simplex keratitis, recurrent corneal erosion

Evaluation:

• Visual acuity

• Fluorescein staining of corneal defect as seen with enhanced corneal magnification, such as with a fluorescent light.

• Evert upper lid to observe for a foreign body.  Fluorescent lamp will outline the foreign body

Treatment:  In general terms, is to encourage healing while preventing infection and relieving patient discomfort.

• Antibiotic Ointment (erythromycin or bacitracin every 2 to 4 hours)

• Antibiotic Drops (polymixin B or trimethoprim one drop qid)

• Contact lens users (floroquinolone, ciprofloxacin, or gentamycin one drop every 4 hours)

• Cycloplegic agent (dilating)

• Cyclopentolate 1-2% or Homatropine 1% one drop qid for two days,

• Patching:  optional, unless contact lens related and then do not patch. 

• USE OF TOPICAL ANESTHETICS IS TO BE CONDEMNED IN LONG-TERM TREATMENT 

• Use oral analgesic to control pain

• See patient every day until healing complete; monitor closely for a corneal ulcer.                            

Causes:  The more common causes will usually be from injury from fingers accidentally thrust into the eye, or from foreign material blown into the eye and subsequent rubbing of the eye.    

Prognosis (consequences):  Generally the prognosis of this kind of injury is good.  Occasionally it can lead to incomplete healing and a condition known as corneal erosion (chronic abrasion). 

This condition may generally lead to a period of sick-in-quarters (SIQ) or light duty for 24 to 48 hours depending on the extent of the abrasion and the job of the patient.  

Small abrasions heal in 24 hours, larger and more resistant to therapy may take 48 to 72 hours to resolve.      

This section provided by CAPT Robert B. North, Jr., MC, USN

Approved for public release; Distribution is unlimited.

The listing of any non-Federal product in this CD is not an endorsement of the product itself, but simply an acknowledgement of the source. 

Operational Medicine 2001
Health Care in Military Settings

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