Eye surface damage affects the cornea and conjunctiva, leading to pain, redness, and vision disturbance. It can result from mechanical, chemical, infectious, or immune‑mediated injury.
Mechanisms
Common causes include corneal abrasions, foreign bodies, contact lens overwear, chemical splashes, severe dry eye, and exposure from incomplete lid closure. Infections, allergic reactions, and autoimmune conditions can also erode or ulcerate the surface.
- Even minor abrasions are very painful due to dense corneal nerve supply
- Alkali burns and infectious ulcers are ophthalmic emergencies
- Chronic exposure or dryness can create persistent epithelial defects
- Topical anaesthetic misuse can cause serious surface toxicity
Consequences
Untreated damage may lead to scarring, infection, or perforation, with permanent visual loss. Prompt protection, irrigation where appropriate, and professional care are crucial.
- Chemical injuries require immediate, prolonged irrigation before assessment
- Contact lens wear should cease at the first sign of significant discomfort
- Protective eyewear reduces the risk of mechanical injury
- Systemic disease causing recurrent erosions may need specialist treatment
