Corneal abrasions are disruptions of the integrity of the corneal epithelium that generally heal rapidly, usually within 24 to 72 hours.1
However, potential complications include scarring, corneal perforation, superinfection, or infectious keratitis. While the most common cause of a corneal abrasion is trauma, it might also occur as a spontaneous defect, or be caused by abrasions from a contact lens or as a result of a foreign body and its removal.
Innervation of the cornea is primarily by the ophthalmic division of the trigeminal nerve and the oculomotor nerve. Symptoms and signs of a potential corneal abrasion include tearing, reluctance of the child to open his or her eyes, the sensation of a foreign body in the eye, photophobia, and redness or injection of the conjunctiva. Visual acuity might or might not be affected by a corneal abrasion. In some younger children corneal abrasions might be manifested as irritability and crying. In one study,2
nearly 50% of neonates (N = 96, aged 1 to 12 weeks) presenting for well-child appointments had corneal abrasions and neither irritability nor sleep disruption were predictors of the presence of corneal abrasions in this population. Thus, one should not attribute irritability in a neonate to a corneal abrasion without a multisystem review to exclude more serious conditions.2
Pain, however, can be associated with corneal abrasions and might interfere substantially with children’s daily functions, including their sleep, school attendance, and other activities. Pain relief is often imperative for the comfort of children.