Corneal abrasion in children

AN eye injury during play is quite common, and any number of things could cause them. One of the more common of these injuries is corneal abrasion. This, according to paediatrician at Gateway Plaza Dr Anona Griffith, is a scratch or injury to the cornea caused by a foreign object. “The coloured portion (iris) of the eye is covered by a clear, multi-layered, dome-shaped structure called the cornea. By virtue of its location and function, it is susceptible to injury. Injury to the outer (superficial) layer of the cornea is known as corneal abrasion,” Dr Griffith said.She explained that the causes of an abrasion are numerous and include mild trauma such as dust particles becoming trapped under the lids, most often from the sandbox at the playground, and from contact with a playmate’s fingernail.Dr Griffith further explained that while this could easily affect any child, some children are more vulnerable than others.“There are some conditions that can predispose to corneal abrasions; these include participation in certain types of sports, eye conditions, including dry eyes, allergic eye conditions that are associated with itchy eyes, eye infection and exposure to chemicals.”While your child vigorously rubbing his/her eye to get rid of the foreign object may be enough to get any parent’s attention, Dr Griffith said a parent should take note of and listen to complaints that could include any number of associated symptoms, including:•Pain in the eye, especially with opening and closing•Headache•Redness•Irritating feeling of something in the eye•Blurring or loss of vision (fogginess)•Watery eyes•Light sensitivityIn general, corneal abrasions are painful for children, especially those who tend to rigorously rub their eyes. This often causes soreness and redness of the eye, and even swelling from the persistent rubbing. However, the problem usually resolves in a few days.“Once there is a suspicion of any form of injury involving the eye, if the cause is identified, the eye may be rinsed before seeking medical attention. If the trauma is more than superficial, that means there is a need for urgent medical attention. The eye may be covered without pressure before seeking help,” Dr Griffith advised.She said that in non-superficial cases, parents should always first consider including an ophthalmologist in the management of the condition, since their specialisation directly focuses on eye care. She argues that they will assist in confirming the diagnosis and deciding whether there are other conditions to be considered, including threat to vision loss.Dr Griffith said this particular diagnosis is generally achieved by taking a detailed history to identify the events surrounding the injury. Examination of the eye is carried out, including the use of a special lamp called a slit lamp along with a dye (Fluorescein) which, when applied to the surface of the eye, will highlight the abrasion.“Treatment is symptomatic and includes pain management and the prevention of infection by the use of antibiotics applied directly to the eye. Additionally, parents are expected to monitor the eye to ensure that there is resolution, and no progression to a repeated problem,” Dr Griffith cautioned.