Welcome to Case of the Day!
A patient came in, a young woman, who actually had permanent eyeliner applied and then afterwards had severe pain. It turns out that at some point during the procedure, she actually suffered a corneal abrasion.
What is a Corneal Abrasion?
The cornea is the clear part in front of the blue or brown portion of your eye. The corneal dome sits over, and then there’s fluid between your iris and your cornea. There are different layers to your cornea. The outer epithelium is a layer of cells that, just like the skin, covers the outer part. Then there’s a stroma level, an endothelium, and a couple of other membranes.
When someone gets a corneal abrasion, these outer cells are torn loose. In this particular individual, it is possible that an instrument or some other object struck the eye during the permanent eyeliner procedure, causing the abrasion. This lady had a large abrasion that covered about 30% of the whole corneal area, and she was in severe pain. The size of that abrasion is probably going to take five or six days to heal. Someone can have a very small abrasion; it can still be very painful, but in almost 24 hours, that abrasion can heal.
How Do People Get Corneal Abrasions?
Corneal abrasions can be caused by a variety of things. Commonly, we see young mothers with children who accidentally poke them in the eye. We also see people who get poked in the eye during sports, whether they are playing basketball, football, or others. We also have altercations where people get into fights. Corneal abrasions can occur for other reasons as well, like in this particular case.
What Do We Do About a Corneal Abrasion?
When someone has a corneal abrasion, we typically prescribe antibiotic eye drops to prevent the abrasion from becoming infected while it heals, like when you have an open sore on your skin. It’s not such a big deal having a little scar if you had a mild infection on your skin as it heals, but when you’re talking about the surface of your cornea, any scarring, especially if it’s located in your pupil, could result in vision loss, which you don’t want to happen.
We may also put them on some pain medication for a few days, depending on the size of the abrasion. Sometimes it depends on the individual. We will put a patch over the affected eye for the first day just to let it heal, so that the eyelid’s not rubbing up and down on that abrasion, which can be very painful. Often, we patch the eye shut after applying antibiotic ointment, which provides people with a little extra relief.
There are cases where we can actually place a soft contact lens over the cornea, covering the abrasion and providing relief, and allowing the abrasion to heal underneath the contact lens. Sometimes, we don’t do anything and just let it heal on its own, and the eye’s not patched at all. That depends on the patient’s comfort level; some people don’t like the feel of a patch on their eye, and some people find that it provides relief. We let the individual choose.
As long as the abrasion is limited to those cells that have been torn loose and they heal back, then typically that person heals well. Everything’s normal and okay again. There are rare instances where people have suffered such an injury, and as the cells heal back together, there are little hemidesmosomes—little hooks that connect our cells to each other, so otherwise we would fall apart if the cells don’t stick together—that don’t attach well. Sometimes hemidesmosomes don’t attach really well, and people can get what’s called recurrent corneal erosion. When this happens, the cells are not totally normal, and it can be that when the individual wakes up one morning years later, their eyes are a little dry, and those cells are torn off, and they’re in pain again. Every morning when they wake up, they tear a few cells off and they’re in pain again. Many times, that is also related to someone who has dry eyes.
If you have any questions or concerns about corneal abrasion, talk to our team at the Cataract & Refractive Institute of Florida today! If not, may God bless you with healthy eyes and great vision.
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At the Cataract & Refractive Institute of Florida, our board-certified ophthalmologist, Dr. James E. Croley III, uses state-of-the-art tools and techniques to help his patients manage their eye conditions. Dr. Croley is a member of the following professional organizations:
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