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Updated: Jun 16, 2026
Corneal Epithelial Abrasion with Ocular Burr As a Model for Cornea Wound Healing
Published on: July 10, 2018
Corneal abrasions in young infants
Timothy R Shope1, Thomas S Rieg, Nazima N Kathiria
1Department of Pediatrics, Naval Medical Center Portsmouth, 620 John Paul Jones Circle, Portsmouth, VA 23708, USA. timothy.shope@med.navy.mil
Insights
Corneal abrasions are common in young infants, affecting nearly half of those studied. While not linked to fingernail length or crying, abrasions may be associated with increased sleep duration in infants.
Area of Science:
- Ophthalmology
- Pediatrics
- Neonatology
Background:
- Corneal abrasions are a common pediatric concern.
- Understanding their prevalence and associated factors in infants is crucial for appropriate clinical management.
Purpose of the Study:
- To determine the prevalence of corneal abrasions in infants aged 1 to 12 weeks.
- To investigate potential associations between corneal abrasions and fingernail length, demographics, sleep patterns, and crying behavior.
Main Methods:
- A questionnaire was administered to parents of infants presenting for well-child visits.
- Fingernail length was measured, and eye examinations were performed using fluorescein staining and specialized lighting.
- Logistic regression analysis was used to identify associations with corneal abrasions.
Main Results:
- Nearly half (49%) of the 96 infants studied had corneal abrasions.
- No significant associations were found with demographic variables, crying duration, fingernail trimming, or fingernail length.
- Infants with corneal abrasions showed a trend towards sleeping more hours.
Conclusions:
- Corneal abrasions are highly prevalent in young infants but their clinical significance remains unclear.
- Physicians should exercise caution when attributing unexplained crying to corneal abrasions, as this may mask other serious conditions.
Objectives:
We sought to determine the prevalence of corneal abrasions and possible associations with fingernail length, demographic information, sleeping, and crying among young infants.
Methods:
Parents of 1- to 12-week-old infants without symptoms who were presenting for well-child visits completed a brief questionnaire on age, gender, race, fingernail-trimming practices, and sleeping and crying in the preceding 24-hour period. Fingernail length was measured, and eyes were examined through staining with fluorescein and illumination/magnification with a Bluminator (Eidolon Optical, Natick, MA). Patients with corneal abrasions were given orally administered acetaminophen and erythromycin ointment. Masked interrater reliability for abrasions was measured. Logistic regression analyses determined the association of corneal abrasions with potential covariates.
Results:
Ninety-six subjects were enrolled, including 47 girls (49%), with a mean age of 32.2 days (SD: 21.7 days). Forty-seven infants (49%) had abrasions. Demographic variables and mean crying times (114.8 +/- 124.9 vs 86.5 +/- 111.7 minutes; P < .24) were not significantly different for infants with and without abrasions. Infants with abrasions slept more (15.9 +/- 3.3 vs 14.5 +/- 3.6 hours; P = .054). Associations of fingernail-trimming method and fingernail length with corneal abrasions were not statistically significant. Masked interrater reliability was high, with agreement between the primary investigator and the associate investigator for 20 (91%) of 22 eyes and agreement between the primary investigator and a pediatric ophthalmologist for 9 (90%) of 10 eyes.
Conclusions:
Corneal abrasions are extremely common among 1- to 12-week-old infants and have unclear clinical significance. Primary care physicians should be careful about attributing unexplained persistent crying to corneal abrasions, potentially missing a more-serious problem.
