A scratched eye, medically known as a corneal abrasion, is a scrape on the cornea, the clear, dome-shaped front surface of the eye. This layer acts as the eye’s outermost protector and helps focus light for vision. Corneal abrasions are common injuries in children, often caused by a stray fingernail, dirt, or a toy. While usually not serious, these injuries are painful because the cornea contains a high density of nerve endings.
Recognizing Signs of a Corneal Scratch
A child with a corneal abrasion exhibits distinct physical and behavioral symptoms. The most noticeable sign is intense pain in the affected eye, causing the child to be hesitant to open the eye or attempt to hold it shut. They experience a foreign-body sensation, describing it as a gritty feeling or the persistent sense that something is trapped in the eye.
The injury triggers a defensive response, resulting in excessive tearing and noticeable redness. Sensitivity to light, known as photophobia, is a common symptom that causes discomfort even in low light. Parents may observe the child blinking more frequently as the eye attempts to clear the irritation.
Immediate First Aid Steps for Eye Injuries
Prevent the child from rubbing the injured eye, as this action can worsen the abrasion or introduce infection. If you suspect a foreign object caused the scratch, a gentle rinse can help flush out loose particles. Use a sterile saline solution or clean, lukewarm water.
A safe rinsing method involves using a clean, small glass with its rim resting on the bone at the base of the eye socket. Tilt the child’s head so the water runs across the eye and away from the face to wash away debris. Never attempt to remove a foreign object embedded in the eye with cotton swabs, tweezers, or fingers. If the child is in pain, administer over-the-counter pain relief suitable for their age, such as acetaminophen or ibuprofen, according to package directions.
Critical Indicators for Emergency Care
Certain signs indicate a severe injury requiring immediate medical attention. Seek care if you observe visible blood in the clear part of the eye (hyphema), which suggests significant internal trauma. If a foreign object is embedded in the eyeball and cannot be rinsed out, seek emergency care.
Rapid or significant changes in the child’s vision, such as sudden blurriness, double vision, or loss of sight, require attention. Watch for symptoms that worsen dramatically, including pain, redness, or swelling. The appearance of a thick, yellow or green pus-like discharge suggests a potential infection that must be addressed by a medical professional.
Professional Diagnosis and Recovery
When seeking professional care, the doctor uses a local anesthetic drop to numb the eye for examination. To confirm the abrasion, a special yellow dye called fluorescein is applied to the eye’s surface. The dye adheres to the damaged area, making the scratch visible under a cobalt blue light, usually using a specialized microscope called a slit lamp.
Treatment focuses on preventing infection and managing discomfort. Antibiotic eye drops or ointment are prescribed to protect the healing cornea for several days. Small abrasions heal quickly, with surface cells regenerating within 24 to 72 hours. Following the prescribed medication schedule is important, and the child must avoid wearing contact lenses until given clearance by a doctor.