corneal abrasion

A scratch on the eyeball is a very painful experience, as anyone who has had a corneal abrasion can testify. It is diagnosed by history ("I got something in my eye and boy it hurts!") and an exam of the eye using a harmless yellow dye (fluorescein) illuminated in a dark room with an ultraviolet light. The abrasion will light up and be easily seen.

If the cornea (the clear top layer of the eyeball) did not have the ability to heal rapidly and especially without scarring, within a few years we would all have permanently clouded vision from the fine little scratches we get in everyday life. Fortunately, the cornea heals itself rapidly and does not scar.

Treatment of corneal abrasion is simplicity itself: usually a little antibiotic (ointment or drops) is prescribed. Formerly the practice was to patch corneal abrasions overnight; it turns out that this is not really necessary. Minor corneal abrasions thus treated will heal semi-miraculously overnight; deeper abrasions may take a day or two longer. I feel most comfortable rechecking these daily until they are healed.

One rare but little-considered cause of unconsolable crying in a young infant is corneal abrasion. A fluorescein stain of the eyes of the baby who won't stop crying may show a scratch caused by a too long, sharp little fingernail rubbed accidentally in the eye as the baby roots around. Antibiotic drops are probably in order, and perhaps patching if it really seems to help. I doubt it is necessary in this instance, either.

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