Recurrent Corneal Erosion: Symptoms, Causes, Treatment

What are the symptoms of recurrent corneal erosion?

Recurrent corneal erosion is a condition where the corneal epithelium, the outermost layer of the cornea, repeatedly breaks down and fails to heal properly. The symptoms of recurrent corneal erosion can be quite distressing and may include:

Eye Pain: Sudden, severe pain in the affected eye is a common symptom. The pain is often sharp and can be described as burning or aching. It may be more intense upon waking.
Redness: The eye may appear red or bloodshot due to inflammation.
Tearing: Excessive tearing or watery eyes can occur as the eye attempts to protect itself from irritation.
Blurred Vision: Vision may become blurred or hazy, particularly when the cornea is affected by erosion.
Sensitivity to Light: Increased sensitivity to light (photophobia) can occur, making bright lights uncomfortable or painful.
Foreign Body Sensation: A sensation that something is in the eye, often described as feeling like a grain of sand or debris, is common.
Discharge: There may be a clear or slightly yellowish discharge from the eye, although this is less common.
Eyelid Sticking: The eyelid may stick to the cornea while sleeping, leading to further damage when the eyelid is opened upon waking.
Visual Disturbances: Recurrent corneal erosion can cause visual disturbances, such as glare or halos around lights, especially in bright conditions.

These symptoms can be triggered or worsened by factors such as eye trauma, dry eyes, or exposure to wind or dust. If you experience any of these symptoms, it’s important to consult an eye care professional for proper diagnosis and treatment.

What are the causes of recurrent corneal erosion?

Recurrent corneal erosion occurs when the outer layer of the cornea (the corneal epithelium) repeatedly fails to adhere properly, leading to repeated episodes of pain and discomfort. Several factors can contribute to this condition:

Previous Corneal Injury: Trauma to the cornea, such as from a scratch or foreign body, can lead to scarring or weakening of the epithelial layer, making it more prone to recurrent erosion.
Corneal Dystrophies: Certain inherited corneal dystrophies, such as epithelial basement membrane dystrophy (EBMD) or Reis-Bücklers dystrophy, can cause abnormalities in the corneal epithelium, increasing the risk of recurrent erosion.
Dry Eye Syndrome: Insufficient tear production or poor tear quality can lead to dryness and irritation of the corneal surface, which may contribute to the development or worsening of recurrent corneal erosion.
Infection: Previous or ongoing corneal infections, such as herpes simplex keratitis, can damage the corneal epithelium and make it more susceptible to erosion.
Contact Lens Use: Extended or improper use of contact lenses, especially if they are not cleaned properly or fit poorly, can cause mechanical irritation and damage to the corneal surface.
Eye Surgery: Certain eye surgeries, including corneal surgery or procedures that involve the corneal surface, can disrupt the epithelial layer and increase the risk of recurrent erosion.
Poor Wound Healing: Conditions that impair the healing of corneal wounds, such as diabetes or autoimmune disorders, can predispose individuals to recurrent corneal erosion.
Exposure to Irritants: Frequent exposure to environmental irritants like smoke, wind, or dust can exacerbate corneal dryness and contribute to erosion.
Systemic Medications: Certain medications that affect tear production or corneal health may increase the risk of recurrent corneal erosion.

Understanding the underlying cause of recurrent corneal erosion is important for selecting the appropriate treatment and preventing future episodes. If you suspect you have this condition, consulting with an eye care professional is crucial for diagnosis and management.

What is the treatment for recurrent corneal erosion?

Treatment for recurrent corneal erosion aims to relieve symptoms, promote healing, and prevent future episodes. The approach depends on the severity and underlying cause of the condition. Common treatments include:

Conservative Measures

Lubricating Eye Drops: Frequent use of preservative-free artificial tears or lubricating eye ointments helps keep the cornea moist and reduces irritation. These are especially useful to prevent dryness and protect the corneal surface.
Hypertonic Saline Drops: Hypertonic saline drops can help reduce corneal swelling and improve adhesion of the epithelial cells to the corneal surface.
Bandage Contact Lenses: A soft contact lens can be used as a protective barrier over the cornea. This helps to reduce friction and allows the epithelium to heal more comfortably.

Medical Treatments

Antibiotic Drops: If there is an associated infection or risk of infection, antibiotic eye drops may be prescribed to prevent or treat bacterial infections.
Anti-Inflammatory Drops: Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroid eye drops may be used to reduce inflammation and pain. However, corticosteroids are generally used cautiously and for short durations due to potential side effects.
Punctal Plugs: In cases of dry eye contributing to the erosion, punctal plugs can be inserted into the tear ducts to help retain moisture on the corneal surface.

Surgical and Advanced Treatments

Debridement: In cases where conservative measures are not effective, a procedure called debridement may be performed. This involves gently removing the damaged epithelial cells from the cornea to promote better healing and adhesion.
Anterior Stromal Puncture: This technique involves creating small punctures in the corneal stroma (the middle layer) to stimulate healing and improve adhesion of the epithelial cells.
Laser Treatment: In some cases, laser treatment such as phototherapeutic keratectomy (PTK) may be used to remove damaged corneal epithelium and promote better healing. PTK can also smooth the corneal surface and improve adhesion.
Amniotic Membrane Transplantation: For severe or persistent cases, an amniotic membrane graft may be used. This involves placing a thin layer of amniotic tissue over the cornea to promote healing and reduce inflammation.

Preventive Measures

Avoiding Irritants: Protecting the eyes from environmental irritants like wind, dust, and smoke can help prevent episodes of erosion.
Proper Contact Lens Care: If you wear contact lenses, ensure they are properly fitted and cleaned. Follow your eye care professional’s recommendations for lens wear and care.
Managing Dry Eye: Addressing underlying causes of dry eye with appropriate treatments can help reduce the risk of recurrent corneal erosion.

If you experience symptoms of recurrent corneal erosion, it’s important to consult with an eye care professional for an accurate diagnosis and personalized treatment plan.