How to Tell if You Have a Scratched Cornea (& What to Do)
How to Tell if You Have a Scratched Cornea
The most common sign of a scratched cornea is a sharp or burning pain in your eye. You might feel like something is stuck under your eyelid, even after rinsing. Many patients also notice their eye waters constantly and feels very sensitive when exposed to bright lights or sunlight.
These symptoms often appear suddenly after an injury, but they can also develop gradually if a tiny foreign object has been irritating your cornea. If you experience these warning signs, we recommend scheduling an eye exam as soon as possible.
A scratched cornea can make your vision blurry or hazy, especially in the injured eye. Some people see halos around lights or have trouble focusing on objects at any distance.
Redness in the white part of your eye often accompanies these vision changes. The combination of blurred vision and eye redness should prompt you to seek care, since the cornea plays a key role in how light enters your eye and creates clear images.
Certain warning signs suggest a deeper or more serious injury. If you have severe pain that does not improve within an hour, vision loss, or bleeding from the eye, call 911 or go to the emergency department now.
- Pain that gets worse instead of better over the first few hours
- A visible cut or puncture on the surface of your eye
- Discharge that looks white, yellow, or green
- A feeling that your eye is extremely sensitive even in dim lighting
- A chemical splash in the eye
- High-velocity impact from metal-on-metal or power tools
- An object stuck in the eye or a suspected puncture
- An irregular or teardrop-shaped pupil
Do not press on the eye and do not try to remove an embedded object.
Common Causes and Risk Factors
Many corneal abrasions happen during routine activities at home or work. A fingernail scratch from a baby or toddler is one of the most frequent causes we see in our practice. Tree branches, makeup brushes, and even a piece of paper can scrape the cornea if they make contact with your eye.
Dust, sand, or wood particles that blow into your eye can also cause scratches, especially if you rub your eye while the debris is still present. Wearing protective eyewear during yard work or windy conditions can help prevent these injuries.
Ultraviolet light from welding arcs or intense sun reflected off snow can cause a similar corneal surface injury called photokeratitis.
Contact lenses can scratch your cornea if you insert or remove them incorrectly, or if a lens has a torn edge. Sleeping in lenses not designed for overnight wear increases your risk, since your cornea receives less oxygen and becomes more vulnerable to injury.
- Putting in lenses with dry or dirty hands
- Wearing contact lenses past their recommended replacement schedule
- Using lenses that do not fit your eye properly
- Failing to clean and disinfect lenses as directed
Certain activities expose your eyes to a higher chance of corneal injury. Construction work, metalworking, and carpentry often involve flying debris or sparks that can strike the eye. Athletes who play basketball, racquetball, or other fast-paced sports face similar risks from fingers, balls, or equipment.
People who spend time gardening, working with power tools, or handling chemicals should also take precautions. We recommend wearing safety glasses or protective goggles whenever you engage in these activities, even for short periods.
How Our Eye Doctor Diagnoses a Corneal Abrasion
When you come in with symptoms of a scratched cornea, our eye doctor will first ask about your recent activities and when the pain or discomfort began. We will check your vision in each eye and look at the surface of your eye using a special microscope called a slit lamp.
This examination allows us to see tiny details on your cornea and identify any scratches, foreign material, or signs of infection. The exam is usually quick and well tolerated. We use numbing drops in the office if needed.
To make corneal scratches easier to see, we use a safe orange dye called fluorescein. Our eye doctor places a small strip of dye-soaked paper against your lower eyelid, or applies a drop of dye to your eye. When we shine a blue light on your cornea, any scratches glow bright green or yellow.
This test is very effective for revealing even small abrasions that might not be visible under normal lighting. The dye washes out with your tears within a few hours. It may briefly tint your tears or the skin around your eye.
During your exam, we carefully check for any foreign objects embedded in your cornea or hiding under your eyelids. If we find debris, our eye doctor will gently remove it using sterile instruments or by flushing your eye with saline solution.
- Measuring the size and location of the scratch
- Determining whether the injury is superficial or deep
- Assessing whether the scratch has affected multiple layers of the cornea
- Looking for signs of infection or other complications
- If a metallic foreign body is present, removing any rust ring to protect healing
- Considering tetanus status if a penetrating or contaminated injury is suspected
Treatment Options for a Scratched Cornea
Most corneal abrasions require antibiotic eye drops or ointment to prevent bacterial infection while the scratch heals. We prescribe these medications based on the size and depth of your injury, as well as any risk factors you may have.
Use the antibiotic exactly as directed, often several times a day for several days or until the surface has healed. Do not stop early even if your eye starts to feel better.
- Contact lens wearers typically need an antibiotic with Pseudomonas coverage and closer follow-up.
- Do not use steroid-containing or combination drops unless we prescribe them for you.
- For non–contact lens wearers, ointments can improve comfort, especially at bedtime.
Over-the-counter pain relievers like acetaminophen or ibuprofen can help reduce discomfort from a scratched cornea. We may also recommend lubricating eye drops to keep your eye moist and soothe irritation.
A short-acting cycloplegic drop placed in the clinic can reduce light sensitivity and ciliary spasm. Topical NSAID drops are not routinely recommended for home use because of rare healing problems and should only be used with our guidance for short periods. Cold compresses for 10 to 15 minutes at a time can also help discomfort.
In 2025, eye doctors avoid prescribing topical anesthetic drops for home use because they can slow healing and mask symptoms of complications. If you have severe pain, we may recommend other options or see you for more frequent monitoring.
For some larger or more painful corneal abrasions, we may recommend a bandage contact lens. This soft lens acts like a protective shield over your cornea, reducing pain and allowing the surface to heal more comfortably.
- The lens stays in place for several days while the scratch heals
- You will continue using prescribed eye drops over the lens
- Our eye doctor will monitor your healing closely during this time
- There is a small infection risk while wearing a bandage lens, especially in contact lens wearers. You will use prophylactic antibiotic drops and strictly avoid water exposure.
- Do not remove or replace the bandage lens yourself unless we instruct you.
Deeper scratches or abrasions that do not heal within a few days may need additional care. In rare cases, we may refer you to a corneal specialist for treatments such as amniotic membrane therapy or other interventions that promote faster healing and reduce scarring.
If your corneal abrasion was caused by a contaminated object, especially organic material like a tree branch, we will watch carefully for signs of infection and adjust your treatment plan as needed.
Taking Care of Your Eye While It Heals
Proper care at home helps your cornea heal quickly and reduces the risk of complications. Always wash your hands before applying eye drops or touching near your eye, and use medications exactly as our eye doctor prescribed.
- Do wear sunglasses outdoors to reduce light sensitivity
- Do avoid rubbing or touching your injured eye
- Do use preservative-free artificial tears frequently to keep the eye moist
- Do replace or discard any contact lenses and the lens case used around the time of the injury
- Do not wear regular contact lenses until we clear you to resume use
- Do not use makeup on or near your eye until healing is complete
- Do keep follow-up appointments even if you feel better
- Do not use steroid or redness-reducing drops unless we prescribe them
- Do not use leftover or someone else's antibiotic drops
- Do not try to remove a stuck object yourself
- Do not drive until your vision is clear and light sensitivity is manageable
- Do not expose a bandage contact lens to water, pools, or hot tubs
Most small corneal abrasions heal within one to three days, and you can usually return to work or school during this time if your pain is manageable. However, you should avoid swimming, hot tubs, and activities that could expose your eye to dust or debris until your cornea has fully healed.
Do not drive until you can comfortably keep the eye open and your vision is clear.
If your job or hobbies involve physical contact or eye hazards, ask our eye doctor when it is safe to resume these activities. We will let you know based on how your cornea is healing and whether any risk of re-injury remains.
We typically schedule a follow-up visit within one to two days after your initial exam to check your healing progress. During this appointment, our eye doctor will look for signs that the scratch is closing properly and that no infection has developed.
If we placed a bandage contact lens on your eye, we will examine the cornea underneath the lens and decide when to remove it. Continued pain, worsening redness, or new discharge between appointments should prompt you to contact us right away.
When to Seek Immediate Medical Care
Some symptoms indicate a serious problem that needs urgent attention. Sudden vision loss, intense pain that does not respond to over-the-counter pain relievers, or the sensation that something has penetrated deeply into your eye all require immediate care.
- Extreme sensitivity to light that makes it impossible to open your eye
- A white or cloudy spot developing on your cornea
- Increasing redness or swelling around your eye
- Pus or thick discharge coming from your eye
- Chemical splash or burn
- High-velocity metal fragment exposure
- An object that penetrated the eye or an irregular, teardrop pupil
For chemicals, rinse the eye immediately with clean water or saline for at least 15 minutes and go to the emergency department. For a suspected puncture, do not press on the eye, place a protective shield if available, and seek emergency care.
Without proper treatment, a scratched cornea can lead to a bacterial or fungal infection called keratitis. This infection can cause permanent scarring or vision loss if not treated promptly with stronger medications.
Recurrent corneal erosion is another possible complication, where the scratch fails to heal completely and breaks open again weeks or months later. If you experience repeated episodes of pain and tearing, especially upon waking, let our eye doctor know so we can explore preventive treatments.
Frequently Asked Questions
Many minor corneal abrasions do heal without medical treatment, but seeing an eye doctor helps ensure the injury is not serious and reduces your risk of infection. We can also provide relief from pain and monitor your recovery to catch any problems early.
Small scratches often heal in one to three days, while larger or deeper abrasions may take a week or more. The exact healing time depends on the size, depth, and location of the scratch, as well as how well you follow treatment instructions.
Most corneal abrasions heal completely without lasting effects on your vision. However, deep scratches or those that become infected can leave scars on the cornea, which may blur your vision or create glare problems. Early treatment greatly reduces this risk.
You should not wear your regular contact lenses until our eye doctor confirms that your cornea has fully healed. Wearing lenses over a scratch can slow healing, trap bacteria, and increase your risk of a serious infection.
In 2025, we generally do not recommend patching a scratched cornea because studies show it does not speed healing and may actually increase discomfort. Keeping your eye open and blinking naturally helps wash away debris and keeps the surface moist, which supports better recovery.
Start rinsing immediately with clean water or saline for at least 15 minutes, then go to the emergency department. Bring the chemical label if available. Do not delay rinsing while arranging transportation.
Getting Care for a Scratched Cornea
If you think you have a scratched cornea, contact our office for an appointment as soon as possible. Early diagnosis and treatment can relieve your pain, protect your vision, and help your eye heal safely.