At a glance

  • If small objects get in your eye, they can damage your cornea.

  • Scratches on the cornea typically heal on their own.

  • Safety glasses may help protect your eyes during certain activities at work or in your free time.

  • It’s important to go to the doctor if an object is stuck in your eye, if your eye is bleeding or hurts a lot,

  • or if the symptoms don't go away or come back later on.

  • Urgent medical help is needed if you have a serious eye injury.

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's 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’s why it's 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 attach properly. Symptoms may include pain after waking up, sensitivity to light, watery 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 hasn’t changed noticeably, you probably have a minor eye injury such as a scratched cornea.

The following symptoms may be signs of a more severe injury that needs medical attention:

  • You have something stuck up high under your eyelid and it will not come out
  • If you have contact lenses: Your eye is red or uncomfortable
  • Your eye hurts a lot
  • Your eye has changed noticeably
  • Your eye is bleeding or oozing a sticky fluid

If you think you have a more severe eye injury, it's best to have it checked by an eye doctor. If your eye hurts, it's important to describe exactly where it hurts – e.g. on the surface of the eye, inside the eye or only when you move your eye. The doctor will test your vision and the reactions of your pupil too.

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 at home 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 lead to corneal injuries.

Treatment

Your eye tries to flush away foreign objects by watering and blinking. If that doesn't work, you can try to get it out yourself or ask someone else to help you. If the object is on the lower eyelid, for example, you can carefully try to get it out with an unused tissue. It’s important not to start rubbing your eye, even though that’s 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 will need 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 to numb the eye beforehand if necessary.

A superficial corneal injury can be treated with an ointment. Some eye ointments contain muscle-relaxants or antibiotics. Eye-muscle-relaxants make the pupil dilate a lot, 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. Painkillers are available as eye drops or tablets.

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. You need both eyes to be able to judge how close or far away things are.

If you think you might have a serious eye injury, it’s important to seek medical attention quickly. It's then a good idea to carefully cover the eye and have somebody take you to an eye 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 itch or burn.

Research summaries