Corneal Laceration

Updated: Mar 14, 2023
  • Author: Adedoyin Adesina, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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A corneal laceration is a partial- or full-thickness injury to the cornea that can occur from trauma to the eye. A partial-thickness injury does not violate the globe of the eye (abrasion). A full-thickness injury penetrates through all the layers of the cornea, resulting in ruptured globe. These lacerations vary in size, shape, and severity. This article will focus on full-thickness injury.

While history may point to the etiology of the laceration, sometimes the patient may not remember a discrete inciting event. Patients may not recall things such as small foreign bodies, digital trauma, or other subtle sources of damage. 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 experience intense pain, lacrimation, photophobia, and demonstrate conjunctival injection and visual disturbance. 

When evaluating eye trauma with evidence of corneal injury, it is important to assess for full-thickness laceration and the resulting ruptured globe. With a ruptured globe, aqueous humor escapes 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.




United States

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

Approximately 2% of all emergency department visits are due to eye injuries affecting an estimated 24 million Americans. [1, 2]  Additionally, eye injury is responsible for 1.6 million cases of blindness worldwide. [3]  Major risk factors for eye injury include age, gender, and socioeconomic status.  [3]

Penetrating eye injury can occur in individuals of any age, but data from USEIR demonstrate that the mean age of ocular injury is 29 years and the median age is 26 years, with nearly 60% being younger than 30 years.  [4]

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

The Centers for Disease Control and Prevention/National Institute of Occupational Safety and Health features information pertaining to work-related eye injuries. With occupational exposures, more than 90% of eye injuries are preventable with the use of protective eyewear. [1]


International epidemiology of penetrating eye injury reveals similar demographics showing most injuries occur in male, and younger age groups, and the most common location is at home. [5]  In children, a significant amount of the inciting events occurred while they were unsupervised. Local activities such as preparations of explosives, bonfires, and shots of blowguns predispose to corneal injury (eg, fireworks injuries).


Mortality from corneal lacerations is rare, but morbidity can be significant. Corneal lacerations or subsequent secondary infection (endophthalmitis) can result in complete or partial loss of vision, loss of the eye, or systemic infection. Other complications include corneal scarring and cataract formation, and secondary glaucoma can also lead to vision loss. [6]  Early diagnosis and treatment can improve significantly improve outcomes.


Males are about 1.7 times more likely than females to have a penetrating ocular injury. [1]


The majority of patients presenting to the Emergency Department for penetrating eye injury are represented in the less than 40 years age group, making up 77% of the cases. [7] The mean age for eye injury is 29 years. There are also age variations based on the mechanism of injury, consistent with age-specific activities and risk factors. Ocular trauma from reactional sharp injury predominantly occurs in patients less than 20 years. [7] About 75% of patients that sustained an eye injury due to a fall were aged 50 years and older. [7]



The human cornea comprises the following 6 layers: epithelium, Bowman's layer, stroma, Dua's layer, Descemet's membrane, and endothelium. An injury and defect to the epithelium leaves the eye susceptible to infection. Injury involving the Bowman's and deeper layers are likely to result in corneal scarring and consequently limit visual clarity. The non-regenerating cells of the endothelium house the sodium-potassium channels that keeps the cornea dry and clear. Violation of the endothelium results in a cloudy edematous cornea.



The prognosis after corneal laceration depends on the extent of the injury. Factors to consider include but are not limited to location, length, depth, and complexity of laceration, as well as the degree of scarring. Extensive corneal scarring may affect vision, requiring corneal transplant in the future. Laceration involving deeper globe structures such as the lens, retina, and uveal tissue may have a guarded prognosis.


Patient Education

Individuals should seek immediate medical attention if there is suspicion of injury to the eye or if they experience eye pain, redness, excessive tearing, vision loss or change. 

A physician's evaluation will be centered on visual inspection of the effected eye(s) and may include visual acuity testing, fluroscein staining exam, ocular pressure measurement, removal of any visible foreign bodies, CT imaging, and consultation with an ophthalmologist. 

Prevention of eye injuries is paramount anytime one could be exposed to small projectiles such as when working with wood or metal or participating in shooting sports or other outdoor activities.