60.4 Injuries of the cornea and sclera

The common corneal injuries are abrasions and lacerations. The danger of an abrasion is that it may become infected, so that a corneal ulcer forms, followed perhaps by endophthalmitis. A corneal laceration is the most difficult eye injury that you may have to treat.

If a laceration goes right through a patient’s cornea so that his aqueous escapes, his iris may move up against its posterior surface, or prolapse outside it (J, 60-6). If a laceration is small, and its edges are not separated, you may not need to suture it. A clean wound of the cornea heals rapidly, especially if only the epithelium is injured. If a wound goes deeper than this, a scar always forms.