Corneal Laceration 

  • Author: Andrew A Aronson, MD, FACEP; Chief Editor: Barry E Brenner, MD, PhD, FACEP   more...
 
Updated: Apr 12, 2011
 

Background

A corneal laceration is a partial- or full-thickness injury to the cornea. A partial-thickness injury does not violate the globe of the eye (abrasion). A full-thickness injury penetrates completely through the cornea, causing a ruptured globe. This topic discusses the full-thickness injury.

History sometimes points to a discrete event after which the patient’s symptoms started; however, this is not always the case. Small foreign bodies, digital trauma, or other more subtle sources of damage may not be quickly recalled by the patient. The physician must be meticulous in examining the cornea and periorbital structures if there is suspicion of a corneal laceration. Typically, patients who present with this type of injury complain of an intensely painful, profusely lacrimating eye. The bulbar conjunctiva will be injected with prominent blood vessels.

The first priority in evaluating a corneal injury is to include or exclude a full-thickness injury and the resulting ruptured globe. A full-thickness injury will allow aqueous humor to escape the anterior chamber, which can result in a flat-appearing cornea, air bubbles under the cornea, or an asymmetric pupil secondary to the iris protruding through the corneal defect.

For more information, see Medscape's Cornea and External Disease Resource Center and Medscape's Ophthalmology Specialty page.

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Epidemiology

Frequency

United States

The United States Eye Injury Registry (USEIR) is a terrific resource for nationwide eye trauma epidemiology, prevention techniques, and educational resources.

Penetrating eye injury can occur in individuals of any age, but data from USEIR demonstrate that the mean age of the patient with an ocular injury is 29 years (median age, 26 y), with nearly 60% being younger than 30 years.[1]

The American Academy of Ophthalmology also has statistics available. These data suggest similar trends to the USEIR data.

The Centers for Disease Control and Prevention/National Institute of Occupational Safety and Health has information pertaining to work-related eye injuries.

International

International epidemiology of penetrating eye injury has similar demographics of who is likely to sustain corneal injury: males, between the ages of 25 and 30 years, associated with alcohol ingestion, injury occurring at home. Be aware of any local activities or traditions that may also predispose the local population to corneal injury.

Mortality/Morbidity

Mortality from corneal lacerations is rare. However, morbidity from corneal lacerations is significant. Corneal lacerations or subsequent secondary infection (endophthalmitis) can result in complete or partial loss of vision, loss of the eye, or systemic infection.

Sex

Males are more likely than females to have penetrating ocular injury.

Age

Although ocular trauma can occur in persons of all ages, most injuries occur in those aged 25-30 years.

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Contributor Information and Disclosures
Author

Andrew A Aronson, MD, FACEP  Vice President, Physician Practices, Bravo Health Advanced Care Center; Consulting Staff, Department of Emergency Medicine, Taylor Hospital, Ridley Park, Pennsylvania

Andrew A Aronson, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, Massachusetts Medical Society, and Society of Hospital Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Nelson M Yang, MD  Staff Physician, Department of Emergency Medicine, Allegheny General Hospital

Disclosure: Nothing to disclose.

Specialty Editor Board

William K Chiang, MD  Associate Professor, Department of Emergency Medicine, New York University School of Medicine; Chief of Service, Department of Emergency Medicine, Bellevue Hospital Center

William K Chiang, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Medical Toxicology, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Douglas Lavenburg, MD  Clinical Professor, Department of Emergency Medicine, Christiana Care Health Systems

Douglas Lavenburg, MD is a member of the following medical societies: American Society of Cataract and Refractive Surgery

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Barry E Brenner, MD, PhD, FACEP  Professor of Emergency Medicine, Professor of Internal Medicine, Program Director, Emergency Medicine, University Hospitals, Case Medical Center

Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, Arkansas Medical Society, New York Academy of Medicine, New York Academy of Sciences, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

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