Recurrent Corneal Erosion
erosion is a condition affecting the outermost layer of corneal cells
called the epithelium. The problem is caused when the bottom layer of
epithelial cells adhere poorly to the cornea, causing them to slough off
easily. The pain and discomfort is often quite intense, and similar to a
corneal abrasion. There is usually an underlying disorder that causes
recurrent corneal erosions to occur. The most common are: previous
corneal injury (corneal abrasion), corneal dystrophy (Map Dot
Fingerprint Dystrophy), or corneal disease resulting in recurrent
breakdown of the epithelial cells.
Upon awakening, patients often experience severe pain, blurred
vision, and light sensitivity when the eyelid pulls the loosened
epithelial cells off the cornea. After the cornea heals, the problem
recurs as the name implies unless the condition is treated. Recurrent
corneal erosion may affect one or both eyes, depending on the underlying
Signs and Symptoms
• Severe pain (especially after awakening)
• Blurred vision
• Foreign body sensation
• Dryness and irritation
• Light sensitivity
DIAGNOSIS AND DETECTION
Using a slit
lamp microscope, the doctor examines the corneal layers under high
magnification. Eye drops containing green dye called fluorescein are
usually instilled to stain the areas of missing epithelium, allowing the
doctor to evaluate the size and depth of the erosion.
Salt solution drops or ointment are usually prescribed as
the first line of treatment. This medication helps the epithelium to
adhere better to Bowman's layer of the cornea. Artificial tears are also
recommended to keep the cornea moist.
Those with underlying
corneal dystrophy may require additional treatment. This usually
includes an in-office procedure where the epithelium is either gently
removed, or microscopic "spot welds" are made on the cornea to encourage
the epithelial to bond securely to Bowman's layer underneath.
Patients who continue to suffer from recurrent corneal erosions despite
the treatments described, may benefit from phototherapeutic keratectomy
(PTK). This involves removal of the superficial layer of corneal cells
using the Excimer laser to encourage proper healing.