Corneal Abrasion Treatment: How to Treat a Scratched Cornea

What is a Corneal Abrasion?

A corneal abrasion is a scratch or scrape on the cornea, the clear outer layer at the front of the eye. The cornea helps protect the eye and plays an important role in focusing light, so damage to its surface can cause noticeable discomfort and changes in vision.   

Corneal abrasions can happen in many ways. A fingernail, tree branch, makeup applicator, contact lens, or small particle of dust, dirt, sand, wood, or metal can scratch the eye’s surface. In some cases, rubbing the eye while debris is trapped underneath the eyelid can also cause an abrasion.   

Because the cornea contains many sensitive nerve endings, even a small scratch may feel very painful. Symptoms can include tearing, redness, sensitivity to light, blurry vision, or the sensation that something is still in the eye. If symptoms are severe, vision changes occur, or the discomfort does not improve, an eye doctor can examine the eye and determine whether additional treatment is needed.

What Does a Corneal Abrasion Feel Like?

A corneal abrasion can cause noticeable discomfort, even when the scratch is small. Many people describe the sensation as feeling like there is sand, grit, or another object stuck in the eye. The eye may also sting, burn, or feel increasingly irritated when blinking.   

Common symptoms of a corneal abrasion can include: 

• Eye pain or stinging 

• Redness 

• Excessive tearing or watery eyes 

• Sensitivity to light 

• Blurry or hazy vision 

• A gritty or foreign-body sensation 

• Difficulty keeping the affected eye open 

Symptoms can vary depending on the size and location of the abrasion. If you experience significant vision changes, severe pain, increasing redness, or symptoms that continue to worsen, it is important to have your eye evaluated by an eye care professional.

What Should You Do Immediately After Scratching Your Eye?

If you think you have scratched your eye, avoid rubbing or pressing on it. Rubbing can irritate the cornea further and may worsen the injury, especially if dust, dirt, or another small particle is still present.   

You can gently rinse the eye with clean water or sterile saline to help remove loose debris. Blinking several times may also encourage natural tears to flush out small particles. If you wear contact lenses, remove them and avoid putting them back in until the eye has healed and your eye doctor says it is safe to resume wearing them.   

Do not use tweezers, cotton swabs, or other objects to try to remove anything that appears stuck or embedded in the eye. You should also avoid using leftover prescription eye drops or someone else’s medication. If an object will not rinse out, pain is significant, vision is affected, or symptoms do not begin to improve, contact an eye care professional for an evaluation.  

How Are Corneal Abrasions Treated?

Treatment for a corneal abrasion depends on the size and cause of the scratch, whether anything is stuck in the eye, and whether there are signs of infection or another injury. Contact lens use can also affect treatment because certain eye infections are more common among contact lens wearers.   

For many uncomplicated corneal abrasions, treatment focuses on protecting the eye from infection, managing discomfort, and allowing the cornea to heal. An eye doctor can examine the injury and recommend treatment based on your specific needs.

Removing or Flushing Out a Foreign Body

If dust, dirt, or another small particle caused the abrasion, removing the foreign material may be an important first step. Loose debris may sometimes be flushed from the eye with sterile saline or clean water. If something remains trapped beneath the eyelid or on the surface of the cornea, an eye care professional can remove it safely using appropriate instruments and magnification. 

Do not attempt to remove an object that appears embedded in the eye. Injuries involving metal fragments, power tools, high-speed debris, or other potentially penetrating objects require prompt professional evaluation. 

Antibiotic Eye Drops or Ointment

An eye doctor may prescribe antibiotic eye drops or ointment to help reduce the risk of infection while the corneal surface heals. The treatment selected may depend on how the abrasion occurred and whether the patient wears contact lenses. 

Contact lens-related abrasions require particular attention because contact lens wear can increase the risk of certain corneal infections. If you develop a corneal abrasion while wearing contacts, remove your lenses and do not resume wearing them until your eye doctor says it is safe to do so. 

Lubricating Eye Drops Ointments

Lubricating eye drops or ointments may be recommended to keep the eye comfortable and reduce friction as the corneal surface heals. These products can help soothe irritation and dryness while the damaged surface cells recover. 

Not every type of eye drop is appropriate for a scratched cornea, however. Avoid using leftover prescription medications or eye drops that were prescribed to someone else. An eye doctor can recommend products that are appropriate for your injury. 

Pain Relief

Because the cornea contains many nerve endings, even a small abrasion can be painful. Depending on the severity of the injury, an eye doctor may recommend an appropriate option for managing discomfort while the eye heals. 

Numbing eye drops may be used by an eye care professional during an examination, but they generally should not be used at home unless specifically directed by a qualified clinician. Prolonged or improper use of topical anesthetic drops can interfere with healing and may cause serious corneal complications. 

Dilating Eye Drops

For some larger or more painful corneal abrasions, an eye doctor may use prescription drops that temporarily dilate the pupil. These medications can help reduce painful spasms of the muscles inside the eye that sometimes occur after a corneal injury. 

Dilating drops are not necessary for every abrasion. Whether they are appropriate depends on the symptoms, size of the injury, and findings from the eye examination.

Bandage Contact Lenses

In certain cases, an eye doctor may place a special bandage contact lens over the cornea. Unlike ordinary contact lenses used to correct vision, a bandage lens is used as a medical treatment to protect the injured surface, reduce friction from blinking, and provide greater comfort while the cornea heals.   

Bandage contact lenses require professional supervision because wearing a lens over an injured cornea can increase infection concerns. Patients should follow their eye doctor's instructions for follow-up care and should not try to treat an abrasion by putting their regular contact lenses back in.

When Should You See an Eye Doctor for a Corneal Abrasion?

Some minor corneal abrasions may begin to improve quickly, but an eye exam is important when symptoms are severe, persistent, or getting worse. An eye doctor can check for a deeper injury, retained foreign material, infection, or other conditions that may cause similar symptoms.   

Contact an eye care professional if you experience:

• Severe or worsening eye pain 

• Blurry, decreased, or otherwise changing vision 

• Increasing redness or swelling 

• Discharge from the eye 

• A persistent feeling that something is stuck in the eye 

• Symptoms that are not improving as expected 

• An injury caused by metal, wood, plant material, or high-speed debris 

• A corneal abrasion related to contact lens wear 

• An object that cannot be rinsed from the eye 

How Long Does a Corneal Abrasion Take to Heal?

Many small, uncomplicated corneal abrasions begin to feel better within 24 to 48 hours and may heal within a few days. The cornea has a strong ability to repair its surface, but healing time can vary depending on the size, depth, location, and cause of the abrasion. 

Larger abrasions or injuries complicated by infection, contact lens use, or retained debris may take longer to heal and may require follow-up care. Pain and light sensitivity should generally improve as the corneal surface recovers, although some irritation may remain for a short period. 

If your symptoms are not improving, become more painful, or return after initially getting better, contact an eye doctor. In some cases, the corneal surface may not heal normally or may reopen later, a condition known as recurrent corneal erosion. An eye care professional can evaluate the eye and determine whether additional treatment is needed.