Corneal Abrasions and Lacerations
By Melissa Gottschalk, ATC
How do they occur?
A corneal abrasion, or laceration, is an injury that occurs from a foreign object entering the eye or from blunt trauma to the eye. The degree of penetration of the cornea determines if it is an abrasion or laceration. An abrasion usually results from dirt, sand, or contacts entering the eye and getting caught between the eyelid and the cornea. This creates an unpleasant feeling and traditionally causes the person to blink causing more pain. Since the debris is caught in between the two it scratches the cornea. When a foreign object actually penetrates the eye a corneal laceration occurs. A partial tear presents more like a corneal abrasion but the trauma will be visible. A full tear can be apparent if there is an irregularly shaped pupil or if the contents of the cornea can be viewed.
Signs and Symptoms
Corneal abrasion: watering eyes, conjunctiva (inside of lower eyelid) redness, small foreign object may be present, possibly sensitive to light, pain described as “there’s something in my eye” regardless of whether there is, obvious damage or abrasion are not necessarily observed.
Laceration: obvious damage to the cornea, irregularly shaped pupil, watering eyes, conjunctiva redness, small foreign object may still be present, possibly sensitive to light, pain described as “there’s something in my eye” regardless of whether there is.
Diagnosis
A corneal abrasion can be diagnosed using a fluorescein dye. The dye is applied to the conjunctiva. The patient blinks to spread the dye around. The lights in the room are turned down and a cobalt blue light is shined into the eye which will reveal a bright yellow-green is an abrasion is present. A corneal laceration is traditionally diagnosed through observation of the eye and then a thorough exam from an ophthalmologist.
Treatment
A corneal abrasion can be given antibiotic drops to help prevent infection and will be healed traditionally within a couple days to a week.
A corneal laceration will also be given antibiotic drops and an antibiotic ointment that will be used until healed; generally one to three weeks.
•It’s important to note that if a foreign object actually has penetrated the eye to leave it in there until further medical attention can be utilized. If the foreign body is removed without a physician or an ophthalmologist‘s approval more damage could potentially occur to the eye.
For easy transport the eye should be covered with a patch that does not apply pressure to the eye but will help block more foreign articles from entering the eye.
Prognosis
The recovery is usually very successful for corneal abrasions and lacerations. As long as the foreign object that penetrates the eye doesn’t cause damage to the optic nerve the cornea should be able to heal with following directions from the ophthalmologist.
http://www.nlm.nih.gov/MEDLINEPLUS/ency/article/001017.htm
Starkey, C., Ryan, J. (2002). Evaluation of orthopedic and athletic injuries (2nd Ed.). Philadelphia, PA: F. A.
Davis Company.
 Melissa Gottschalk, ATC is a first year graduate student and recipient of the Hughston Athletic Training Fellowship in Columbus, Georgia. She graduated from Southeast Missouri State University in December of 2007 with a Bachelors Degree in Health Management with an emphasis in Athletic Training. While attending Southeast, she completed rotations with gymnastics, men’s basketball, baseball, football, men’s and women’s track and volleyball. In addition to her responsibilities at Southeast, Melissa also completed a rotation at Cape Central High School and Health Point Fitness center, as well as an internship at the University of Missouri-Columbia. Melissa was a member of the Gamma Phi Beta sorority and the Health, Human Performance, and Recreation Honor Society. Awards received while at Southeast included: Gamma Phi Beta Senior of the Year 2007, Dean’s list, and Scholar Athlete Awards. She is an active member of the National Athletic Trainer’s Association (NATA), as well as an active member of First Presbyterian Church, Missouri, in which she has attended several mission trips sponsored by the Reach Program. Melissa has been assigned to and will oversee the healthcare of the athletes at Hardaway High School in Columbus, Georgia.
|
Corneal Abrasions and Lacerations