S05.01XA–Corneal abrasion, initial encounter, right eyeS05.01XD–Subsequent encounter, best eyeS05.01XS–Sequela of corneal abrasion, best eyeS05.02XA–Corneal abrasion, initial encounter, left eyeS05.02XD–Subsequent encounter, left eyeS05.02XS–Sequela of corneal abrasion, left eye

TitleSuperficial Injury of Cornea

CategorySuperficial Injury Of Eye And Adnexa

DescriptionA corneal abrasion is a scrape or scrape of the cornea. It deserve to outcome from international bodies, call lenses, chemicals, or anything resulting in mechanical trauma such as fingernails, hair brushes, vegetative matter, dust, metal shards or projectile objects.

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DEFINITION

Corneal abrasions are identified as injuries to the a lot of superficial layer of the cornea, the epithelium.


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Conjunctival Foreign Body-Induced Corneal AbrasionForegime body installed under the top eyelidEyelid evariation is necessary to identify the etiology

NATURAL HISTORY

Structural Damage to the Eye 

Damage of the cornea at a superficial level — break does not involve Bowman’s membraneDamage of the corneal at a deeper level — break penetprices Bowman’s membrane, however does not rupture Descemet’s membrane

Functional Damage to the Eye 

Blurred vision as an outcome of the compromised cornea Corneal edema have the right to result from the insult to the cornea relying on the level of damage
DIAGNOSTIC EVALUATION

The main goal of the diagnostic testimonial of a patient with corneal abrasion is to accomplish the following:

Assess the amount of structural damages to the corneaReduce patients symptomsManage pain accordinglyPrevent additionally damages to the corneaReduce re-occurrence of damage to the cornea in the time of the healing process

Patient History

Patients through corneal abrasion might current through any kind of of the complying with clinical symptoms:

Acute painTearingPhotophobiaBlurred visionForeign body sensationBlepharospasmPain with eye movements

External Ocular Examicountry with Biomicroscopy

Meacertain the dimension of the abrasion by making use of fluorescein dyeEvaluate the anterior chamber for indications of ocular inflammation (e.g., cells and also flare)Rule out penetrating trauma
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Clinical Appearance of the EyelidFirst, evert the top eyelid and also scrutinize the palpebral conjunctiva, the ocular surface and also conjunctival fornices to ascendancy out the existence of foreign material

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Clinical Appearance of the ConjunctivaVegetative issue embedded on the upper tarsusFopower bodies trapped under the top eyelid tfinish to create vertically-oriented direct abrasions

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Clinical Appearance of the CorneaEvaluate the cornea with fluorescein dye to determine the dimension, shape, place and also depth of the corneal abrasion (superficial versus deep penetration)

DIAGNOSTIC TESTS

External Ocular Photography 

Used to document degree of corneal damage
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CLASSIFICATION

Two categories of corneal abrasions deserve to occur: superficial or deep abrasions.

Superficial abrasions perform not involve Bowman’s membrane.

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Deep abrasions pass through Bowman’s membrane, yet perform not rupture Descemet’s membrane.


DIFFERENTIAL DIAGNOSES

Recurrent Corneal Erosions

The symptoms of pain, discomfort and also photophobia are the same; but the etiology of the corneal damages is very different (the instance background is very essential in distinguishing the two)Corneal abrasions are generally caused by international bodies, call lenses, chemicals, or some create of traumaReexisting corneal erosion take place from rubbing their eyes or opening their eyes or upon awakening from sleep — typically months after a history of a corneal abrasion from some mechanical trauma

Corneal Ulcers 

The symptoms of pain, discomfort and photophobia are equivalent, however patients via ulcers likewise report redness, watery eyes or mucopurelent discharge as wellUsually there is a history of call lens wear or some develop of trauma left untreated to build into a corneal ulcer

Herpes Simplex Keratitis

The symptoms of pain, discomfort and also photophobia are the same; yet the etiology of the corneal damage is extremely various (the situation background is incredibly crucial in differentiating the two)Patients via Herpes simplex will not report an initiating insult that led to the corneal damage

Treatment options differ depending upon the cause of the corneal abrasion. Patients through contact lens-induced abrasions must have anti-pseudomonas coverage.

Phamacologic Therapy — Cycloplegia 

Traumatic iritis might construct one-to-3 days after the initial injury. Use cycloplegics only because steroids may delay epithelial healing and increase the risk of corneal infection.

Atropine 1% for severe abrasions Homatropine 5% for modeprice abrasions Cyclopentolate 1% for mild abrasions

Pharmacologic Therapy — Topical Antibiotic

Fourth generation fluoroquinolones (Vigamox, Zymar, Ocuflox, Quixin, Besivance) for big abrasions Polytrim, Gentamycin, Tobramycin for little abrasionsOintments or drops may be used, but ointments market much better barrier function and lubrication between the eyelid and the cornea