Cornea
Corneal Abrasion
Also known as: corneal abrasion, scratched cornea, corneal scratch, corneal epithelial defect, corneal injury, eye scratch, fingernail eye injury, corneal trauma
Filed as: Soon
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
Overview
Disruption of the corneal epithelium by trauma — the most common acute eye injury presenting to primary care. Causes immediate, severe eye pain, photophobia, and tearing. Diagnosis is confirmed by fluorescein staining. Most abrasions heal within 24–72 hours with topical antibiotic and lubricants. The key concern is to exclude a corneal foreign body or penetrating injury.
Recognition
Symptoms: what patients report
- Sudden onset severe eye pain — often immediately following an identified trauma event.
- Foreign-body sensation — persistent even if no foreign body is present.
- Marked photophobia.
- Profuse tearing.
- Blepharospasm — involuntary lid closure from pain.
- Blurred vision — from tearing and pain-induced blepharospasm.
- History of: fingernail, paper, plant material, twig, contact lens removal, or occupational exposure.
Signs: what the examination shows
- Fluorescein staining: epithelial defect that stains bright green under cobalt-blue illumination — defines the abrasion.
- Conjunctival injection.
- Anterior chamber: clear, no cells or flare (if cells present, consider traumatic iritis).
- Corneal sensation: intact (helps exclude HSV keratitis).
- Evert upper lid: check for retained foreign body — essential if the cause is unclear.
- Topography of the abrasion: linear scratch (fingernail), vertical striped pattern (subtarsal foreign body), circular ring (contact lens-related).
What OptoGuide™ covers for corneal abrasion
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked Australian therapeutics
- Referral urgency, specialty, and letter drafting
Sources
- Corneal abrasion — College of Optometrists CMG
- Anterior Eye Disease and Therapeutics A-Z (Bruce & Loughnan) — standard reference text
- Wilderness Medical Society Clinical Practice Guidelines for Treatment of Eye Injuries and Illnesses in the Wilderness: 2024 Update. Paterson R, Drake B, Tabin G, Cushing T. Wilderness & Environmental Medicine. 2024;35(1_
- Eye Infections. Durand ML, Barshak MB, Sobrin L. The New England Journal of Medicine. 2023;389(25):2363-2375.
- Interventions for Recurrent Corneal Erosions. Watson SL, Leung V. The Cochrane Database of Systematic Reviews. 2018;7:CD001861.
Standard texts: Kanski's Clinical Ophthalmology: A Systematic Approach, The Wills Eye Manual, Oxford Handbook of Ophthalmology, Oxford American Handbook of Ophthalmology, Signs in Ophthalmology: Causes & Differential Diagnosis.