Introduction

Photo of a man cycling (PantherMedia / Stefan Schurr)

There are plenty of situations where small objects can easily enter your eye – for instance, while riding a bike, gardening or playing on the beach. If an object gets into your eye it can damage the surface of the cornea. This is known as “corneal abrasion” or “corneal erosion.” It is not always visible.

If you have a corneal abrasion it can feel like there’s still something in your eye – even if the object has been removed. Corneal abrasions usually heal completely within two or three days. But they can sometimes lead to complications, so it may be better to see a doctor.

Symptoms

The transparent cornea of the eye contains many fine nerve fibers, which react very sensitively to touch and injury. That is why it is so uncomfortable when a foreign object like a grain of sand or a small insect enters the space between your eyeball and your eyelid, or gets under your contact lens. Your eye starts to hurt and it waters. If the cornea is scratched, it will feel as though something is stuck in your eye. Other possible symptoms include sensitivity to light and blurry vision.

Causes

Normally, our eyelashes, eyelids and tears work together to stop objects from entering our eyes, or to quickly flush them out if they do get in. The firm and elastic cornea helps to protect the highly sensitive eyeball from injury. Minor injuries to the cornea are still quite common, though. The most common cause is when something gets stuck under the eyelid or a contact lens.

A lot of different things could harm our eyes: a little twig that gets blown into your face while running in the woods, the fingernail of a toddler who unexpectedly stretches their hand out, or a poorly placed contact lens. Foreign objects may also get into your eye during home improvements or as a work-related injury, for instance when using a milling machine or welding.

Outlook

Superficial corneal abrasions usually heal within a few hours or days. If symptoms return after a couple of weeks or months, you might have recurrent corneal erosion (RCE). Here the cornea can’t heal because the new cells don’t grow back properly. Symptoms may include pain after waking up, sensitivity to light, watering eyes, cramps in the eyelid and blurry vision.

Recurrent corneal erosion is quite rare: It occurs in less than 1 out of 100 people who have a minor eye injury.

Diagnosis

If the symptoms stop after a couple of hours and your eye has not changed noticeably, you probably have a minor eye injury such as a scratched cornea. But the foreign object might have gone deeper into your eye, even if it doesn’t hurt or isn’t bleeding. The following symptoms may be signs of a more severe injury:

  • You have something stuck up high under your eyelid and it will not come out
  • You wear contact lenses and your eye is red or uncomfortable
  • Your eye hurts a lot
  • Your eye has changed visibly
  • Your eye is bleeding or producing discharge

If you think you have a more severe eye injury, it is a good idea to have it checked by an eye doctor.

Prevention

A lot of work-related eye injuries can be prevented by wearing safety glasses. At dangerous workplaces in Germany and similar countries, there are safety regulations to protect your eyes from hazards such as sanding, drilling, welding and exposure to acids.

But it is just as important to protect your eyes when doing DIY or gardening. Safety glasses that completely cover the eyes are particularly recommended when doing work above your head with your head tilted back so you can look up, and when using a hammer and chisel or sanding something. If small particles and bits of metal break off they can hit the eye at a high speed and become deeply lodged.

It’s important to take care while gardening too: Activities like re-potting plants with prickly leaves or thorns can also lead to corneal injuries.

Treatment

Your eye tries to flush away foreign objects by watering and blinking. You can also try to get the foreign object out yourself or ask someone else to help you. If the object is on the lower eyelid, for example, you can try to get it out with an unused tissue. You should not start rubbing your eye, even though that is often the natural reflex. Rubbing can damage the cornea, especially if the object in your eye is hard or has sharp edges. If possible, you should avoid touching the cornea when trying to remove the foreign object.

If you get chemicals in your eye, the first thing you should do is try to wash your eye as thoroughly as possible with plenty of clean water.

If you are unable to remove a foreign object yourself, you should get help from an eye doctor. Doctors can carefully lift your eyelid and quickly remove any foreign matter. Eye drops with a local anesthetic can be used if necessary.

Superficial corneal injuries can be treated using an eye ointment. Some eye ointments contain muscle-relaxants or antibiotics. Eye muscle-relaxants make the pupil dilate considerably, causing the eye to become temporarily more sensitive to light and blurring your vision. You can use a painkiller like ibuprofen to relieve any pain in your eye.

Eye patches usually aren’t used for minor eye injuries. Studies have shown that they don’t speed up the healing process, and could in fact slow it down. Only being able to see through one eye isn’t only frustrating, it can also increase the risk of further accidents. This is because we need both eyes to be able to see in three dimensions (3D).

If you think you may have a serious eye injury, it’s important to visit an eye doctor as soon as possible. It is then a good idea to carefully cover the eye and have somebody take you to a doctor or hospital, preferably an eye clinic. You could cover it with a cupped hand, for instance. Above all, do not touch or rub your eye, no matter how much it might burn or itch.

Research summaries

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Please note that we do not provide individual advice on matters of health. You can read about where to find help and support in Germany in our information “How can I find self-help groups and information centers?”

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