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Corneal superficial injury - Making a diagnosis
How do I know my patient has it?
- Corneal superficial injury usually presents with discomfort of the eye or a sensation of a foreign body and a watering eye.
- Other symptoms may include pain associated with eye movement, blurring of vision, reduced visual acuity, or photophobia.
- There is usually a history of trauma from:
- Grit.
- Fingernails.
- Plants.
- Paper.
- Contact-lens problems (e.g. poor fit or trapped foreign body).
- If there is no history of trauma ask about a possible high-velocity injury (chiselling, grinding, hammering, or lawn mowing) that may have gone unnoticed.
- On examination the eye may be red (ciliary injection) and the loosened corneal epithelium may have a translucent appearance. To exclude serious causes of red eye, see Differential diagnosis.
- Examine the eye for:
- An abrasion — use fluorescein to stain the conjunctiva and cornea. An abrasion will stain bright green in normal light, and viewing with a cobalt-blue filter enhances this appearance.
- A foreign body on the conjunctiva or under the upper lid (by eversion). If available, use a magnifying glass to help with inspection.
[Eagling and Roper-Hall, 1986; Newell, 1996]
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