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Corneal Abrasion

Abrasions of the cornea are problematic with Lasik, Bladeless Lasik, Epi-Lasik, RLE, and P-IOL.

Image of woman with eyelid inflammed and closed.  
Any corneal abrasion will present severe eye pain.  

A corneal abrasion is a scratch on the cornea. When there is trauma to the cornea, such as with a finger or object, the epithelium, Bowman's layer, and stroma of the cornea can be scratched, resulting in a corneal abrasion. A patient with a corneal abrasion undoubtedly should not have conventional or custom wavefront Lasik, Bladeless Lasik, or Epi-Lasik until the corneal abrasion has healed.

Lasik Induced

Conventional or custom wavefront Lasik, Bladeless Lasik, or Epi-Lasik all require the use of a microkeratome that can cause a corneal abrasion or exacerbate an existing abrasion. Newer mechanical microkeratomes that use a metal blade exert less lateral stress on the surface of the cornea and are therefore less likely to cause an abrasion.  The femtosecond laser microkeratome induces very little lateral stress on the surface of the cornea and would be less likely to cause a corneal abrasion.

Lens-based refractive surgery techniques P-IOL and RLE do not involve the surface of the cornea in the same manner as cornea-based refractive surgery and do not have the same probability of causing a corneal abrasion, however a distressed epithelium is predisposed to corneal abrasion in all situations.  Maladies such as ABMD need to be diagnosed and treated before considering refractive surgery. To avoid corneal abrasions, a detailed examination of the health of the eye performed by a competent eye physician is advised.


People with a corneal abrasion will often complain of pain and foreign body sensation. The eye will often be red. Light sensitivity is often reported. Visual acuity may decrease slightly, greatly, or fluctuate.

There are may very serious maladies of the eye that have the same symptoms of eye pain, redness, sensitivity to light, and decreased vision but are not corneal abrasion. Any person who is experiencing these symptoms should be evaluated by an eye physician.


Although the corneal surface will often rapidly heal on its own, it is very important that an eye doctor carefully monitor the progress of healing. The patient may require antibiotics for the eye or other medications.

For some types of corneal abrasion, PTK is a recommended treatment. PTK is essentially PRK for purposes other than refractive error. For this reason, PRK and its cousin LASEK may (emphasis on "may") be appropriate.  Similarly, in some instances Epi-Lasik may be appropriate.

Looking For Best Lasik Surgeon?

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, Bladeless Lasik, PRK, or any refractive surgery procedure, we recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Doctor.

Personalized Answers

If this article did not fully answer your questions, use our free Ask Lasik Expert patient forum.

Recent Corneal Abrasion Medical Journal Articles...

Related Articles

Dry eye in LASIK patients.

BMC Res Notes. 2014;7(1):420

Authors: Azuma M, Yabuta C, Fraunfelder FW, Shearer TR

BACKGROUND: Increasing age is a known risk factor for developing dry eye. The specific aims of the present study were to determine the prevalence of dry eye syndrome (DES) and use of post-operative dry eye medications in a relatively young population presenting for LASIK surgery at an academic ophthalmology clinic.
FINDINGS: A retrospective, analysis of 948 de-identified patient charts (median age 39 years, not age stratified) was performed to extract pre-LASIK diagnoses and post-LASIK medication lists. Clinical evaluation for DES and the results of Schirmer's reflex tear flow test were used to assign LASIK patients into Normal, Pre-dry eye (Pre-DES), and Dry Eye Syndrome (DES) groups; which were then compared for use of dry eye medications.Based on pre-operative diagnoses, only 2% (CI: 1.3 - 3.1) of LASIK patients presented with overt DES. Unexpectantly, 25% (CI: 22.2 - 27.6) of LASIK patients labeled Pre-DES were not classified by the clinician as having overt DES, yet they showed poor reflex tear flow rates ≤ 5 mm before surgery, and frequently used post-operative lubricant dry eye medications.
CONCLUSIONS: Although the number of patients with pre-existing eye conditions was unknown, a sizable portion of relatively young LASIK patients displays poor reflex tear flow without overt DES. Such patients could go on to develop more serious consequences of poor tear flow, such as corneal abrasion and erosion. More specific, dry eye medications may be needed for ideal treatment.

PMID: 24994125 [PubMed - in process]


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