Combien de temps met une éraflure de la cornée à cicatriser ?

Une simple éraflure de la couche superficielle (épithélium) cicatrise le plus souvent en 24 à 72 heures, car cette couche se régénère très vite. Une plaie plus profonde ou un ulcère peut demander plusieurs semaines et laisser une cicatrice.

Pourquoi ma cornée ne cicatrise-t-elle pas ?

Une cicatrisation qui traîne (défect épithélial persistant) est souvent liée à un œil sec sévère, à une baisse de la sensibilité de la cornée (kératite neurotrophique), au diabète, à un déficit en cellules souches du limbe ou à une infection. Un bilan permet d'en trouver la cause et d'adapter le traitement.

Une cicatrice de la cornée fait-elle baisser la vision ?

Cela dépend de sa localisation et de sa profondeur. Une cicatrice périphérique et superficielle gêne peu ; une cicatrice centrale ou profonde peut opacifier la cornée et réduire la vision. Dans ce cas, des traitements existent, jusqu'à la greffe de cornée si nécessaire.

Corneal healing: understanding it, supporting it, watching it

Name: Corneal healing: understanding, supporting, monitoring
Creator: Pr Eric E. Gabison

The cornea is the clear window at the front of the eye. When it is injured — a scratch, an ulcer, or after surgery or an infection — its ability to heal properly determines your vision. Most injuries heal quickly and without consequence, but some heal poorly and need specific care. Here is how the cornea heals, why it can go wrong, and what can be done.

Scratch / abrasionUlcerAfter surgeryPersistent epithelial defectNeurotrophic keratitis

Corneal ulcer or delayed healing, after surgery or spontaneous? Urgent consultation →

Why the cornea is a special case

Unlike skin, the cornea must stay perfectly transparent to see well. A "visible" scar here leaves an opacity that can blur vision. The cornea also has no blood vessels: it is fed by tears, the aqueous humour and oxygen from the air. This lack of vessels preserves its clarity, but also makes healing slower and more delicate than a skin wound.

How the cornea heals, layer by layer

Cross-section of the cornea: epithelium, Bowman's membrane, stroma, Descemet's membrane and endothelium — **The five layers of the cornea.** The epithelium, at the surface, renews itself within days; the stroma, which makes up 90 % of the thickness, heals far more slowly. This difference explains why healing times vary so widely from one injury to another.

The cornea has three main layers, and they do not heal in the same way:

The epithelium (surface) regenerates very fast: a simple scratch usually closes in 1 to 3 days, leaving no mark.
The stroma (thick central body) heals slowly. A deep injury can leave a scar (opacity) that is more or less bothersome depending on its location.
The endothelium (inner layer) barely renews itself in humans. If it is damaged, the cornea can swell (oedema) and turn hazy; an endothelial graft is sometimes needed.

When healing is delayed: the causes

A persistent epithelial defect is a surface wound that does not close as expected. The most common causes are:

Severe dry eye and inflammation of the ocular surface.
Reduced corneal sensation (neurotrophic keratitis) — after shingles, herpes, diabetes or surgery: the cornea can no longer "feel" and heals poorly.
A limbal stem cell deficiency (the stem cells at the corneal rim are essential to renew the surface).
An infection (corneal ulcer), exposure (eyelids that close poorly), or some eye drops used for too long.

Warning signs

Seek care quickly, especially if you wear contact lenses or have had surgery, in case of:

Pain that persists or worsens.
Marked redness and light sensitivity.
Blurred vision or a haze over the eye.
A foreign-body sensation that won't go away, watering, or a white spot on the cornea.

How healing is supported

Treatment depends on the cause and ranges from the simplest to the most specialised:

Intensive lubrication (preservative-free artificial tears, gels) and treatment of dryness and inflammation.
A bandage contact lens or patching, to protect the surface while it closes.
Autologous serum drops (made from your own blood), rich in healing factors.
Newer treatments: nerve growth factor (cenegermin) for neurotrophic keratitis, and regenerating matrix drops.
Amniotic membrane graft, scleral lenses, and, in resistant cases, ocular surface reconstruction (stem cell grafting).

Scarring and vision

Once healed, the cornea may keep a scar. A thin, peripheral scar causes little trouble. A central or deep scar can reduce vision: depending on the case, options include surface treatment, laser, a rigid lens, or a corneal transplant when the opacity is too severe.

Are you a healthcare professional? For an in-depth review, see the expert course "Corneal wound healing" — physiology of epithelial & stromal repair, myofibroblasts & TGF-β, fibrosis (haze), epithelial–stromal interactions (CD147/MMP), angiogenic privilege & neovascularization.

This page is for general information and does not replace a medical consultation. Any corneal wound or infection should be assessed promptly by an ophthalmologist. Pr Eric E. Gabison — corneal and ocular surface surgery, Fondation Adolphe de Rothschild, Paris.

→ A question about your situation? Ask it here, or browse the answers already given to frequently asked questions.