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Corneal abrasions are a common form of ocular trauma presenting to the primary care office. When the cornea is injured or damaged, sight-threatening consequences are a possibility, especially in the contact-lens wearing patient. Contact lenses can compromise the corneal epithelium and may facilitate the development of bacterial keratitis. The astute clinician will be well-versed in recognizing the signs and symptoms of corneal abrasion to ease the patient's pain and provide proper medical management to hasten visual recovery.
Damage to the corneal epithelium results in loss of the connections of the surrounding epithelial cells, but Bowman's layer should remain intact. The speed by which the abrasion resolves can be affected by a variety of factors including whether or not the patient has diabetes, corneal denervation, dry eye, lagophthalmus, recurrent corneal erosions, or basement membrane changes. In general, an epithelial insult will recover within 3 to 5 days and is accomplished by having the neighboring epithelial cells slide over and begin covering the wound. Total loss of the corneal epithelium can take weeks to fully recover …