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Scratched Cornea vs. Pink Eye: How to Tell the Difference

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A woman holding her right hand against her right eye, due to eye pain

When your eye becomes red, watery, and painful, it’s a sign that something’s wrong. The first step to feeling better is to determine what’s causing it. Could it be a scratched cornea, a scrape on the clear dome on the eye’s surface? Or could it be pink eye, also known as conjunctivitis?

Experiencing common symptoms of both conditions can make it difficult to differentiate them. The difference between the two conditions is that a scratched cornea results from an injury, whereas conjunctivitis is an infection in the eye. 

An experienced optometrist can help you categorize the signs, determine what’s causing the symptoms, and treat the right condition sooner. 

What’s a Cornea? How Does It Get Scratched?

A scratched cornea, or corneal abrasion, can occur when a foreign particle enters your eye. The transparent dome covering your pupil and iris, the cornea, can be scraped by debris.

The cornea contains nerve endings; therefore, scratches can feel painful or uncomfortable. The onset of this pain can be immediate, or you may experience delayed symptoms, making it more challenging to determine what caused it.

Causes of Scratched Cornea

You can get a scratched cornea from several causes. You may scratch your cornea if you:

  • Poke your eye with a fingernail, makeup brush, or other objects
  • Get chemicals in your eye
  • Overwear your contact lenses
  • Neglect wearing protective eyewear during sports or other activities
  • Have certain eye infections
  • Get dirt, sand, ash, or sawdust in your eye

Symptoms

When you scratch your cornea, you may experience the following:

  • A sandy or gritty sensation in your eye
  • Eye pain, particularly when blinking
  • Sensitivity to light
  • Tearing and redness
  • Hazy vision

Treatment

Most corneal abrasions heal quickly. If you know a foreign particle in your eye or your eye’s been scratched, flush your eye immediately with clean water or saline solution. Your optometrist may prescribe antibiotic eye drops, pain-relieving eye drops, or minor pain medication.

Contact your optometrist if you’re experiencing these symptoms. It may be a scratched cornea, but these symptoms are shared with other eye conditions, including conjunctivitis. 

Illustration to represent optometrists checking and diagnosing pink eye

What’s Pink Eye?

Pink eye, also known as conjunctivitis, is a contagious, eye-inflammatory condition characterized by red and watering eyes. The conjunctiva is the thin, transparent layer over the whites of the eye that turns pink when it becomes inflamed.

The redness and overwatering can indicate an infection and need an optometrist’s intervention to begin treatment. Identifying conjunctivitis early can help prevent its spread.

Causes of Conjunctivitis

There are three main types of conjunctivitis: viral, bacterial, and allergic.

Viral Conjunctivitis

The most common form of conjunctivitis and also the most contagious. It can begin in one eye but spread to the other, producing a watery discharge. It can occur with cold, flu, or respiratory illnesses and cause your lymph nodes to swell under your jaw.

Bacterial Conjunctivitis

Bacterial conjunctivitis can affect one eye or both and can sometimes occur with an ear infection. This type of conjunctivitis is more commonly associated with discharge and pus.

Allergic Conjunctivitis

This type occurs with symptoms of allergies such as asthma, sneezing, scratchy throat, and itchy nose.

Symptoms

Symptoms of conjunctivitis vary based on whether it’s a viral, bacterial, or allergic strain. However, some commonly shared symptoms include:

  • Pink or red irritation in the whites of the eyes
  • Swelling of the conjunctiva, the layer that lines the whites of the eyes
  • Increased tear production
  • Discharge of pus or mucus
  • Crusting of the eyelids and eyelashes
  • Discomfort wearing contact lenses
  • The sensation of a foreign particle in the eye
  • Itching, burning or stinging

Treatment

Conjunctivitis treatment differs for viruses, bacteria, and allergic strains. Viral conjunctivitis is often traceable to similar viruses that cause the common cold. This type of conjunctivitis needs to run its course and will typically last between 7 to 14 days.

Good hand hygiene is paramount to prevent the spread as your body slowly clears the virus. In more extreme cases, your optometrist may suggest prescription antiviral eye drops or ointments to speed the healing process.

Bacterial conjunctivitis requires antibiotics to recede. With either ointment, eye drops, or pills, the infection should clear within a week if you follow your optometrist’s treatment directions. 

Conjunctivitis related to allergies can improve if you avoid the triggers and treat your allergy at the source. Antihistamines, or allergy medicine, can help relieve the discomfort but may exacerbate symptoms of dry eye disease.

So, What’s the Difference?

Scratched corneas and conjunctivitis can appear deceptively similar. They share common symptoms such as red eyes, watering eyes, and pain, but they’re different in many other ways.

A scratched cornea is a minor injury to the eye, whereas conjunctivitis is typically a viral or bacterial infection.

Something as simple as an eyelash can cause a scratched cornea, but conjunctivitis occurs when a virus infects the body or bacteria enters the eye.

Take Care of Your Eyes at The Eye Care Centre

Each condition needs to be appropriately diagnosed by an optometrist to begin the proper treatment. A scratched cornea should be examined by a professional to ensure no signs of infection. Conjunctivitis is an eye condition that should be decisively diagnosed to treat the proper strain.

Each eye injury or infection can uniquely affect you. Schedule a comprehensive eye exam with us to tailor a treatment plan to your eyes.

Written by Dr. Daryl Berger

Dr. Berger was born and raised in Red Deer. After studying at Red Deer College and the U of A, he graduated with honours from the optometry program at Waterloo in 2007. Daryl enjoys music, cars, biking, hiking, snowboarding and travel. He and his wife, Pamela, have twin boys and a dog named Gus.
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