A corneal laceration can be 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 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.