Corneal Tear

Definition:

A cut on the clear front window of the eye called cornea is known as corneal tear. Corneal cut can be superficial or deeper. A deep or full thickness cut through the cornea can completely cut the cornea and cause ruptured globe.

Cornea protects the eye and is very important for proper vision. In case, cornea gets scratched, it not only causes pain and discomfort to the patient but can also affect the vision. So any abrasion or cut on the cornea should not be ignored and immediate treatment should be provided to avoid any loss of vision.

Causes of Corneal tear

Corneal tear is generally caused by something striking the eye with significant force. It may result from an injury on the eye’s cornea due to poking of a sharp object (like pen, pencil, stick etc.) or trapping of something (like dust, dirt, sand etc.) into the eye. The main causative factors of corneal tear include the following:

• Corneal or epithelial diseases (e.g., dry eye)
• Superficial corneal injury or ocular injuries
• Accidental or intentional poking by fingernail, plant, pen etc. into the eye
• Blowing of foreign body like sand, dirt, ash etc. into the eye
• Lodging of any foreign body into the upper eye lid an eventually tear the cornea while eye blinking
• Using open grinding machines without protective eyewear can cause metal or other grinding particle to attack the eye. This kind of attack is with greater amount of force and needs to be managed immediately to avoid any loss of vision.
• Burns occurring due to chemicals
• Aggressive rubbing of the irritated eye
• Poor fitting or dirty contact lenses
• Wearing contact lens for more time than prescribed
• Eye infections
• Eyelid margin injuries and avulsions
• Not protecting the eyes during surgery while under general anaesthesia
• Unprotected eye exposure to excessive or prolonged ultraviolet light from sun lamps or welding arcs

Risk factors of Corneal tear

• Previous traumatic eye abrasion
• Underlying defect in the corneal epithelium
• Extreme rough and windy environment
• Carelessness during any kind of play
• Improper use of contact lens
• Eye surgery that ended with sutures in the eye
• Occupational factors like working in grinding mills or welding

Symptoms of Corneal tear

Most of the eye injury cases eventually fall under the category of corneal tear. Nevertheless any kind of corneal tear will show following symptoms in the patient:

• Unrelenting pain in the affected eye
• Severe eye discomfort
• Inability to open the eye
• Foreign body (sand or grit) sensation in the eye (this symptom develops sometime after the injury and not immediately after eye injury)
• Excessive pain in eye especially while opening or closing it
• Tearing from the affected eye
• Eye redness due to internal bleeding
• Blood in the eye
• Sensitivity or eye pain in bright light
• Sometimes headache
• Squint that results due to spasm of muscles surrounding the eye
• Eyelid swelling
• Blurred vision or complete loss of vision

When to seek medical care :

Eye injury is a very serious condition that should not be neglected in any situation. But contrary to this, in reality, eye injury is the most common and most neglected emergency situation.

In case you experience any of the above mentioned symptoms or have encountered any of the causative factor of eye injury, a prompt consultation and thorough eye examination is required.

In fact, patients who previously had an eye injury but now experience any eye related symptom should also consult an eye doctor immediately to avoid any complication or loss of vision.

Diagnosis of Corneal tear

In some cases of corneal tear, the symptoms do not appear immediately and it becomes difficult for the eye doctor to evaluate the cause of tear. A thorough eye examination using a special eye stain is done along with slit lamp examination and fluorescein instillation to find the cause and certain the diagnosis of corneal tears.

Treatment of Corneal tear

Corneal tear needs prompt treatment as if left as such, tear can lead to corneal ulcer. Especially the corneal tear caused by plant requires special attention as they can cause a delayed inflammation inside the eye (iritis).

First of all in any case, if you feel that something is in your eye, do not rub it and try to flush it out with water or blink your eye several times. In case the feeling is still there, seek help from an eye doctor.

Treatment for corneal tear may include any of the following:

• Removal of any foreign body from the eye
• Eye patching
• Antibiotic eye drops
• Pain and inflammation medication
• Surgery may be required to repair a corneal laceration

Complications of corneal tear

If left untreated or not treated properly, corneal tear can cause complications like:

• Retinal detachment
• Severe infection
• Glaucoma