How it arises and how it manifests itself
The surface layer of the cornea - the epithelium - is easily damaged by mechanical stress. Typical scenarios: a tree branch in the face, a child's fingernail, the edge of a sheet of paper, a grain of sand caught under the eyelid that a person tries to wipe off, removing or putting on a lens with dry hands. A sharp pain immediately occurs, the eye waters profusely, it is impossible to open it in the light, and there is a feeling that there is a speck left inside. Vision may become blurred if the center of the cornea is damaged. The eyelid reflexively closes, and this is a protective reaction.
- Sharp pain and burning sensation
- Excessive lacrimation
- Photophobia and inability to open the eye
- Foreign body sensation
- Redness of the eye
- Blurred vision due to a central defect
What to do right away
Do not rub your eyes - this is the main rule: friction deepens the defect and rubs in the foreign body. Rinse the eye with clean water or sterile saline, blinking frequently to flush out the particles. If you feel a speck under your upper eyelid, you can try to pull the upper eyelid down onto the lower eyelid. If a chemical comes into contact, rinse your eye with plenty of running water for at least 15–20 minutes and immediately seek help, if necessary, call 103. Remove contact lenses and do not wear them until examined by a doctor.
- Don't rub your eyes
- Rinse with water or saline solution
- Blink frequently
- Remove contact lenses
- In case of a chemical burn, wash for 15–20 minutes and call for help.
- Put on dark glasses and consult an ophthalmologist
Diagnostics
The ophthalmologist instills anesthetic drops to make the examination comfortable, and stains the surface of the eye with fluorescein: in blue light, the epithelial defect glows green, and its size and shape become visible. Be sure to turn out the upper eyelid and inspect the fornix - a foreign body is often found there, which causes new scratches with every blink. The doctor assesses the depth of the damage, the transparency of the cornea, the condition of the anterior chamber and checks visual acuity. If a penetrating wound is suspected, the examination is expanded.
- Slit lamp examination
- Fluorescein staining
- Eversion of the upper eyelid and examination of the vaults
- Visual acuity test
- Exclusion of penetrating injury
- Culture for suspected infection
Treatment
If a foreign body is found, it is removed under local anesthesia. Then antibacterial drops or ointment are prescribed to prevent infection, as well as moisturizing and healing agents. For lens wearers, medications are selected taking into account the increased risk of infection and the lenses are prohibited until complete healing. An important rule: you cannot continue to drip pain-relieving drops on your own - they slow down healing and can cause severe damage to the cornea. Dark glasses reduce photophobia. A follow-up examination is usually scheduled every other day.
- Removal of a foreign body by a doctor
- Antibacterial drops or ointment
- Moisturizing and healing products
- Avoiding contact lenses until healing occurs
- No painkiller drops on your own
- Dark glasses and checkup
Recurrent erosion and prevention
Sometimes, after an injury, the epithelium is not firmly attached to the underlying layer, and in the morning, when opening the eyes, it comes off again: the person wakes up from sharp pain and lacrimation, episodes are repeated for months. This condition is called recurrent erosion; it is treated with long-term use of moisturizing gels at night, and if it persists, with special procedures on the cornea. Prevention is simple: protective glasses when working with tools, a welding mask, careful handling of lenses and compliance with the terms of wearing them, treatment of dry eyes.
- Morning pain when opening eyes is a sign of relapse
- Long-term moisturizing gels at night
- Treatment procedures for persistent relapses
- Safety glasses when working with tools
- Welding helmet and UV protection
- Hygiene and correct timing of wearing lenses
