It doesn’t take much to scratch your eye.
A fingernail from a toddler. A tree branch while you’re working in the yard. A mascara wand at exactly the wrong moment. Even a tiny piece of dirt trapped underneath your eyelid can scrape across the surface of your eye.
And somehow, a scratch you can’t even see can hurt a lot.
A scratch on the clear front surface of your eye is called a corneal abrasion. Most are relatively minor and heal quickly with the right care. However, a scratched cornea can also become infected or occasionally cause other complications.
So while you may be tempted to wait for that painful, gritty feeling to disappear on its own, there are times when a scratched eye is worth having checked.
A Corneal Abrasion Is Literally a Scratch on Your Eye
The cornea is the clear, dome-shaped tissue covering the front of your eye. Light passes through it before entering the eye, so maintaining a smooth, clear corneal surface is important for good vision.
An eye abrasion occurs when that surface gets scraped or scratched.
Sometimes the cause is obvious. You get poked in the eye and immediately know something happened.
Other times, you may wake up with a red, painful, watery eye and have no idea why. A small particle may have gotten underneath your eyelid, you may have rubbed your eye while something was in it, or an older injury may have disrupted the surface again.
Why Such a Tiny Scratch Can Hurt So Much
One of the first things people notice about a scratched eye is that the amount of pain seems completely unreasonable compared with the size of the injury.
There’s a reason for that.
Your cornea has a very dense supply of nerve endings. That sensitivity helps protect your eye by making you react quickly when something touches or injures it.
Unfortunately, it also means a tiny abrasion can be extremely uncomfortable.
Common corneal abrasion symptoms include:
- Pain
- Redness
- Excessive tearing
- Sensitivity to light
- Blurry vision
- Persistent sensation that there’s something stuck in your eye
Blinking may make the discomfort worse because your eyelid moves directly across the injured surface every time you blink.
The Most Common Ways People Scratch Their Eyes
Corneal abrasions can happen surprisingly easily.
Fingernails are a common culprit, particularly if you have small children. Makeup brushes or mascara wands can scratch the eye, as can paper, plant material, pet paws, and debris kicked up while working outside.
Dust, sand, sawdust, or other small particles can also become trapped beneath the eyelid. Every time you blink, that material may rub against the cornea and create an abrasion.
Contact lenses can contribute too. Wearing lenses too long, sleeping in contacts that aren’t intended for overnight wear, putting in a damaged lens, or handling lenses improperly can irritate or injure the corneal surface.
A contact-lens-related abrasion deserves extra attention because contact lens wear can increase the risk of certain corneal infections.
Sometimes There’s Still Something in the Eye
A scratch isn’t always the whole problem. If your eye started hurting after you were exposed to dirt, sawdust, metal, or another small particle, you may have a foreign body in the eye.
Sometimes that material washes out but leaves a scratch behind. Other times, it remains trapped underneath the eyelid or becomes embedded in the cornea.
That can create the classic sensation that something is still in your eye because, well, sometimes there actually is.
This is one reason an eye that continues to feel painful or gritty after rinsing shouldn’t be repeatedly rubbed in an attempt to “get it out.” If something is embedded in the eye, trying to remove it yourself can cause more damage.
Finding a Corneal Abrasion During an Eye Exam
Many corneal abrasions are extremely difficult to see just by looking in the mirror. During an eye exam, we can use magnification and a special microscope called a slit lamp to examine the surface of the eye closely.
We may also use fluorescein, a yellow-orange dye that temporarily highlights areas where the surface of the cornea has been damaged. Under a special blue light, an abrasion becomes much easier to see.
We can also check underneath the eyelids for debris and look for signs of infection or a deeper injury.
Knowing exactly what caused the pain helps us determine the appropriate corneal abrasion treatment.
Treating a Corneal Abrasion
The appropriate eye abrasion treatment depends on the size and cause of the scratch, whether a foreign body is present, and whether there are any signs of infection.
Fortunately, the cornea heals remarkably quickly.
For a simple abrasion, treatment is generally focused on allowing the surface to heal while keeping the eye comfortable and reducing the risk of infection. Depending on the injury, your eye doctor may prescribe antibiotic drops or ointment and recommend appropriate options for managing discomfort.
If something is still in the eye, it may need to be safely removed before the abrasion can heal.
Scratched cornea treatment can be different for someone who wears contact lenses because certain bacteria associated with contact lens use can cause more serious infections.
What NOT to Do While Your Eye Heals
If you think you’ve scratched your eye, your first instinct may be to rub it. Try not to. Rubbing can make an abrasion worse, particularly if there is still debris underneath the eyelid.
You also shouldn’t try to remove anything that appears embedded in the cornea or use tweezers, cotton swabs, or other objects to investigate your eye.
If you wear contact lenses, leave them out while the cornea heals and don’t put them back in until your eye doctor says it’s safe to do so.
It’s also best not to use leftover prescription eye drops from a previous eye problem. Different conditions can cause very similar symptoms, and some medications aren’t appropriate for an injured cornea.
The first step to treating a scratched eye at home is gently rinsing the eye with clean water or sterile saline. Beyond that, significant or persistent pain is a good reason to have the eye examined rather than continuing to experiment with home remedies.
Most Corneal Abrasions Heal Surprisingly Fast
How long does a corneal abrasion take to heal?
Many small, uncomplicated abrasions improve significantly within 24 to 48 hours. Larger or deeper abrasions may take longer. Because the healing can happen so quickly, you may notice a dramatic improvement from one day to the next.
But improvement doesn’t mean every corneal injury should be ignored. An abrasion that becomes infected can turn into a more serious corneal problem, and an injury that isn’t healing normally may need additional treatment.
When a Scratched Eye Needs Prompt Attention
If you know exactly what happened and your discomfort is mild and quickly improving, you may simply need to keep an eye on it. (See what we did there?)
But significant eye pain, light sensitivity, decreased vision, increasing redness, discharge, or symptoms that aren’t improving should be evaluated.
You should also seek prompt care if something may be embedded in the eye, the injury involved metal or high-speed debris, or you were exposed to chemicals.
Corneal Abrasion FAQ
Can a scratched cornea heal on its own?
Yes. Many small, uncomplicated corneal abrasions can heal naturally because the outer surface of the cornea regenerates quickly. However, an eye doctor may still recommend treatment to reduce the risk of infection, manage discomfort, or address whatever caused the abrasion in the first place.
Can I wear contacts with a scratched cornea?
No. Contact lenses should stay out while a corneal abrasion heals. Wearing a lens over an injured cornea can interfere with healing and increase the risk of infection.
Why does it still feel like something is in my eye?
That sensation doesn’t necessarily mean something is still there. An abrasion itself can create a strong foreign-body sensation. However, debris can also remain trapped beneath an eyelid or embedded in the cornea, which is one reason persistent symptoms are worth having checked.
Don’t Ignore an Eye That Really Hurts
Corneal abrasions are common, and fortunately, most heal very well. But it’s difficult to tell how serious an eye injury is just by looking at it yourself.
A tiny abrasion can be incredibly painful. A foreign body may be hiding underneath your eyelid. And sometimes what seems like a simple scratch can turn out to be something that needs more immediate attention.
At Emerald Point Eye Care, we see eye emergencies and can examine the surface of your eye, remove certain foreign bodies when appropriate, and determine the best treatment to help your eye heal safely. We’d much rather take a look than have you spend the next few days wincing every time you blink.
