flickr.com/ photos/ mkmabus/ 2670562568

The fancy name for these is corneal abrasions.  I see these frequently.  Typically there is a history of trauma and then symptoms of feeling like something is in the eye, tearing and light-sensitivity.

Whenever these symptoms are present, see your doctor the same day.  Serious causes of eye pain (like penetrating eye injury, infective keratitis, and corneal ulcers) need to be excluded

How do doctors see and evaluate these abrasions?  A dye will be painlessly placed on the eye.  A rectangular soft piece of paper will be wetted and placed on the inside of the bottom eyelid and then the dye from the paper will bathe the surface of the eye.  Then, under blue light (see the picture attached) , the abrasion can be evaluated for size, presence of foreign body, and depth.

If a foreign body like dirt or a fleck of metal is still present on the eye surface or underside of the eyelid, this will need to be removed so that further damage to the eye’s surface is avoided.  Pain medicine and antibiotics may be prescribed.  Patching, once popular, is now not suggested as it does not improve pain and has the potential to delay healing.

Referral to an eye doctor may be needed if there is a corneal infiltrate or ulcer, significant vision change or a penetrating eye injury.

Prevention? Yes!  All persons working with metal, wood, machines, or hazardous chemicals (and those in contact sports) should wear protective eyewear.  Polycarbonate lenses offer good protection from projectiles and blunt trauma.  Welders should always wear eye protection that filters UV light.

Close follow-up is needed for corneal abrasions. . . we only get two eyes–two to last a lifetime.