Object Scratching on or scratching eye

Corneal foreign bodies and abrasions

Light objects, especially if not travelling rapidly, may land on and attach to the surface of the eye. Typical examples are rust particles from working under vehicles and metal fragments when using grinding wheels. They may lodge on the cornea or exposed conjunctiva or under the eyelid to form a foreign body.

Scratches to the eye surface (corneal abrasion) are common, for example from twigs, fingernails or paper. Healing generally occurs rapidly. In a minority of cases the new surface does not adhere strongly and repeatedly breaks down, usually on waking, leading to recurrence of the same symptoms, though usually less severe or prolonged. (recurrent corneal erosion syndrome).

Clinical features

Pain
Watering
Photophobia
Foreign body sensation
Redness
Vision near normal
Cornea clear

Management

Foreign bodies can often be wiped away with a cotton bud. If this is not possible see GP or attend an eye casualty department where local anaesthetic eye drops and a microscope will assist removal.

Simple abrasions with good vision are usually managed by the GP/optician with antibiotic eye ointment. Padding the eye may improve comfort. The abrasion will normally heal within 3 days. Poor vision, other injuries or failure to heal require referral to an eye emergency department.

Recurrent erosions often respond to Lacri-lube ointment applied each night for several weeks. If symptoms persist routine referral to an eye department is needed.

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