Recurrent Corneal Erosion

Overview

Recurrent corneal erosion is a condition affecting the outermost layer of corneal cells called the epithelium. The problem is caused when these epithelial cells adhere poorly to the underlying portion of 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 abrasion, corneal dystrophy (an inherited disorder of the cornea), or corneal diseases resulting in recurrent breakdown of the epithelial cells.

The typical scenario involves a patient awakening with or being awakened by severe pain, blurred vision, and light sensitivity when the eyelid pulls the loosened epithelial cells off the cornea. The cornea typically heals rapidly, often in just a few hours. However, as the name implies, the problem tends to recur- anywhere from several days to years later.

Signs and Symptoms

• Severe pain (especially after awakening)
• Blurred vision
• Foreign body sensation
• Dryness and irritation
• Tearing
• Red eye
• Light sensitivity

Treatment

The initial treatment involves the use of salt solution drops and ointment. This helps the epithelium to more firmly adhere to the underlying layer of the cornea. Artificial tears may also be recommended to keep the cornea moist.

If this fails to work, another option involves an in-office procedure where multiple microscopic "spot welds" are made on the cornea in the diseased area to encourage the epithelium to bond securely to the rest of the cornea.

Other patients may benefit from phototherapeutic keratectomy (PTK). This involves the use of the Excimer laser to encourage proper healing after removing the epithelial cells in the abnormal area.