It can happen quickly, whether riding a bicycle or renovating: something small gets into the eye and the foreign body damages the cornea. Superficial injuries usually get better again quickly. But when is medical attention required? And how can small foreign bodies be removed from the eye?
At a glance
- If a foreign body gets into the eye, the cornea can be damaged.
- In certain situations, it is especially easy to get something in the eye – safety goggles can prevent that.
- A scratch on the surface of the cornea is termed corneal erosion.
- Corneal injuries usually heal within 2 to 3 days.
- If symptoms recur several weeks or months later, this may be due to a recurrent corneal injury.
Note: The information in this article cannot and should not replace a medical consultation and must not be used for self-diagnosis or treatment.
When can the cornea of the eye be injured?
Whether cycling, gardening or playing on the beach, there are many situations in which a foreign body can get into the eye. As a result, the cornea of the eye can be injured. A scratch on the surface of the cornea is called corneal erosion. Such an injury is not necessarily visible.
Anyone who has a scratch on the cornea can feel as though the foreign body is still in the eye even though it has already been removed. Corneal erosions normally heal within 2 to 3 days. But if necessary, it is better to see a doctor because there can also be complications.
What makes a corneal injury noticeable?
The cornea is transparent and contains many fine and sensitive nerve fibers. It is therefore unpleasant to get a foreign body in the eye. For example, if a grain of sand or small fly gets between the eyeball and eyelid or under a contact lens, the eye hurts and waters.
If the foreign body causes a scratch on the cornea, it feels like something is stuck in the eye. Sensitivity to light and blurred vision are possible consequences.
What causes an injury to the cornea?
Eyelashes, eyelids and lachrymal fluid ensure that no foreign bodies get into the eye or that they are quickly washed out again. The solid and flexible cornea moreover protects the sensitive eyeball from injuries. But smaller corneal injuries often occur. This is usually when a small foreign body sticks under the eyelid or under a contact lens.
Along with small foreign bodies like grains of sand or flies, larger objects that briefly get into the eye can also damage the cornea: for instance a branch that suddenly strikes the face, or the fingernail of a small child that stretches out its hand unexpectedly. Injuries can also occur when contact lenses are being inserted. Activities like home improvement, work at a milling machine or welding increase the risk of a foreign body getting into the eye.
How long does the pain last in an injured cornea?
Superficial injuries to the cornea usually heal within a few hours or days. If symptoms recur several weeks or months later, a recurrent corneal injury may be present. In this case, the injury to the corneal surface cannot heal because the newly formed cells are not growing properly. People with a recurrent corneal injury can experience a watery eye that is painful after waking up or sensitive to light. Eyelid spasms and blurred vision are also possible symptoms.
Recurrent corneal injuries are relatively rare. Less than 1 out of 100 eye injuries are due to recurrent corneal erosion.
How can injuries to the cornea be prevented?
Occupational eye injuries can often be prevented by wearing safety goggles. That is why there are safety regulations in Germany for jobs in which there is a higher risk of eye injuries. These include for instance jobs like grinding, milling, welding and work with corrosive liquids.
But in the private domain also, it is advisable to protect the eyes when doing these sorts of jobs. Safety goggles that entirely shield the eyes are especially useful in grinding jobs, overhead tasks and work with a hammer and chisel.
It is moreover also necessary to be careful when gardening. That is because many corneal injuries occur during yard work, for example when repotting plants with spiky leaves or thorns.
How is an injury to the cornea diagnosed?
If the symptoms ease after a few hours and the eye does not change noticeably, the injury is probably a minor one like a scratch on the cornea. But even if the eye is neither painful nor bleeds, a foreign body may penetrate deeper into the cornea. The following signs for instance may indicate a more serious injury:
- Something is embedded deeply under the eyelid and does not come out.
- In contact lens wearers, the eye is red or feels uncomfortable.
- The eye is very painful.
- The eye has changed visibly.
- The eye is bleeding or there is discharge.
Anyone who has a more serious eye injury should see an eye specialist.
How can a foreign body in the eye be removed?
If a foreign body has gotten in, the eye attempts to wash it out with tears and blinking. Those affected can moreover try to remove the foreign body themselves or with the help of others. If a foreign body is caught on the lower eyelid for example, an attempt can be made to carefully pick it up with a clean tissue. It is important not to rub the eye – even if urged by a natural reflex to do so. The reason is that rubbing may damage the cornea, especially if the foreign body is angular and hard. Anyone who attempts to remove a foreign body from the eye should therefore avoid touching the cornea as far as possible.
Important: If chemicals get into the eye, first aid entails rinsing out the eye as throughly as possible with plenty of clean water.
If an affected person cannot remove the foreign body on their own, assistance should be sought from an eye specialist. The eye specialist can carefully lift the lid up and remove the foreign body or residue. When necessary, the eye can be locally anesthetized with drops.
Superficial corneal injuries can be treated with an eye ointment. If the eye hurts, analgesics like ibuprofen can help relieve it.
Eye bandages are not normally used with minor injuries. Studies indicate that such bandages do not make healing faster.
You can find more detailed information, such as whether scratches heal better with or without an eye bandage, at gesundheitsinformation.de.
If a severe eye injury is suspected, it is important to see an eye specialist as soon as possible. In this case it is expedient to carefully cover the eye and ask to be taken to an eye specialist or hospital – if possible, an eye hospital.
- Lim CH, Turner A, Lim BX. Patching for corneal abrasion. Cochrane Database Syst Rev 2016; 7(7): CD004764. Aufgerufen am 22.06.2020.
- Wakai A, Lawrenson JG, Lawrenson AL, Wang Y, Brown MD, Quirke M et al. Topical non-steroidal anti-inflammatory drugs for analgesia in traumatic corneal abrasions. Cochrane Database Syst Rev 2017; 5(5): CD009781. Aufgerufen am 22.06.2020.
- Watson SL, Lee MH, Barker NH. Interventions for recurrent corneal erosions. Cochrane Database Syst Rev 2012; (9): CD001861. Aufgerufen am 22.06.2020.
In cooperation with the Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen) (IQWiG). As at: