Corneal Recurrent Erosion Syndrome
What Is The Cornea?
The cornea in is the clear front window of the eye. It is a layer that covers the colored part of the eye (iris) like a watch crystal covers the inside of the watch. The outermost part of the cornea consists of a thin layer of cells called epithelium. Any injury to these cells is quite uncomfortable.
What Is A Corneal Erosion?
An erosion is similar to an abrasion. It is an area of the cornea, which has lost some of its protective outer cells (epithelium), often from trauma. The cornea can be scratched or injured by such things as a contact lens, fingernail, paper cut, twig, vigorous eye rubbing or other external sources. Certain underlying diseases of cornea can also be contributing factors.
What Is Recurrent Erosion Syndrome?
This is a relatively common eye condition, which is very uncomfortable for the patient. The condition is characterized by recurrent episodes of spontaneous breakdown of the surface cells (epithelium) of the cornea. The patient typically experiences irritation or even severe pain upon opening the eye after awakening from sleep in the morning or middle of the night. Patients may also notice eye redness, watering, light sensitivity and blurred vision.
Recurrent erosion syndrome usually begins after trauma, although certain eye conditions such as Anterior Basement Membrane Dystrophy (Map Dot Fingerprint Dystrophy) may also cause the condition. Normally the surface cells of the eye (epithelium) are connected to the underlying tissue by adhesion molecules. During trauma, these molecules may be damaged causing a recurrent tendency to develop erosions or abrasions. Treatment is aimed at healing the surface of the eye (epithelium) as well as repairing the damaged adhesion molecules. Dryness of the eye makes it more likely for recurrent erosions to develop, and treatment is also aimed at keeping the eye very moist.
How Is This Condition Treated?
There are many ways to treat this condition. The treatment process usually involves frequent office visits and requires patience and persistence by both patient and doctor. Therapy usually begins with certain lubricants or medicines including artificial tears, lubricating gels or ointments. Sometimes antibiotics and anti-inflammatory (steroid) drops are also used. Muro 128 drops or ointment is commonly used to help repair the damaged adhesion molecules. This is a salt-based medicine, which help make the surface cells more adherent to the underlying tissue. In certain patients, a bandage-type contact lens or patch may be used. In patients who have recurrent erosions, which are not responding to use of medicines and lubricants alone, a minor procedure performed in the office may be recommended. These include a superficial keratectomy (gentle scraping to remove the damaged surface cells), stromal puncture (placement of small punctures in the surface of the eye to improve adhesion) or in some patients a laser resurfacing procedure.