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Corneal Abrasion

Checked: 23-08-2020 by Vicky Ryan Next Review: 23-08-2021

Overview

Corneal abrasions can occur after trivial trauma and occasionally spontaneously. They often cause significant discomfort when blinking, usually described as a sharp stabbing pain. They may also cause watering of the eye, light sensitivity and reduced vision. They are best visualised with fluorescein applied to the eye and the blue light filter.

Please see diagnostic photographs

Who to refer

It is expected that most primary care doctors refer corneal abrasions as they often lack the equipment to fully diagnose them.

Red Flags

Reduced vision and pain

Before referral

If working in a facility where you can adequately examine the eye:

If the patient has no loose corneal epithelium flap: chloramphenicol ointment TDS for 3-5 days and advise to attend the eye emergency department if symptoms worsen.

If this is a recurrent abrasion, loose epithelium or uncertain of the diagnosis: chloramphenicol ointment TDS for 3-5 days and advise to attend the eye emergency department within 24 hours.

All patients with corneal abrasions should be advised to use lubricants for at least three months following the injury (e.g. Vitapos nocte, hypromellose by day). This is to reduce the incidence of recurrent erosion syndrome.

Referral

Refer to BEH Emergency Department

Resources

These guidelines have been written by Rhys Harrison, consultant ophthalmologist at Bristol Eye Hospital, with thanks to the patients who have kindly given consent to use their photos.

For full ophthalmology guidelines see: Primary Care Ophthalmology Guidance Document

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

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