QUESTION: I am going to evaluate permanent impairment for a person who had a corneal abrasion. I will assess visual acuity; however, should I also assess visual fields, eg, Goldmann-type testing?
ANSWER: It depends on the injury and the context. A corneal abrasion is a lesion in which there is trauma to the corneal epithelium. This common eye injury usually heals quickly, within hours or days. The patient often experiences temporary discomfort. However, a corneal abrasion rarely results in a permanent visual impairment. Therefore, it is imperative to consider the mechanism of injury and also the context. For example, a chemical injury (eg, pepper spray exposure) can cause a peripheral retinal chemotoxic reaction that typically is not observable clinically on dilated fundus examination and would go undetected without the Goldmann visual field test.
Some patients suffer recurrent erosions...