Scratched Cornea vs Pink Eye,How to Tell the Difference

A red, sore eye is one of the most common presentations we see at Prime Optometrists Auburn. Two of the most frequent causes,corneal abrasion and conjunctivitis,can look superficially similar but require completely different management. A corneal abrasion needs urgent treatment and healing support. Conjunctivitis may need antibiotic drops, antihistamines, or simply supportive care, depending on the cause. Using the wrong treatment for either delays recovery and can cause complications.

Corneal Abrasion (Scratched Cornea)

A corneal abrasion is a physical scratch or defect in the corneal epithelium,the outer cell layer of the clear front surface of the eye. It is caused by a foreign body, fingernail, contact lens, or any object that contacts the corneal surface with sufficient force to remove cells.

Key features:

• Intense, sharp pain,often described as a constant stabbing or burning sensation that does not improve
• Severe light sensitivity (photophobia)
• Excessive watering
• Sensation of something still in the eye, even after removal of the foreign body
• Usually has a clear history,a particle in the eye, a scratch, a contact lens event
• Pain does NOT improve with blinking (unlike a surface foreign body that moves)

Conjunctivitis (Pink Eye)

Conjunctivitis is inflammation of the conjunctiva,the clear membrane covering the white of the eye and inner surface of the eyelids. It is not a corneal condition. It can be viral, bacterial, or allergic.

Key features:

• Diffuse redness of the white of the eye
• Discharge,watery (viral/allergic) or thick yellow-green (bacterial)
• Grittiness rather than sharp pain
• Itching (especially allergic conjunctivitis)
• Often both eyes affected, or second eye develops after the first
• Associated with recent cold/flu (viral) or allergy season (allergic)
• Light sensitivity is minimal or absent (unlike corneal abrasion)

When to See Us Urgently

If in any doubt, call us,a slit lamp examination distinguishes these definitively in minutes. Always present urgently for: severe pain, marked light sensitivity, significant vision change, or a known history of something contacting the eye. These features suggest corneal involvement and require prompt assessment.