Dr Ben Wild
Overview |
The cornea is the clear tissue in front of the iris (the colored part) of the eye. The cornea is comprised of 5 layers but can be simplified into 3 main layers; the epithelium (outer most layer), the stroma (middle layer) and endothelium (inner most layer).
Frontal view of a healthy eye.
Recurrent corneal erosions occur when the epithelium dries out at night during sleep, sticks to the back of the eyelids, and upon awakening and opening of the eyelids, rips open. This happens because the epithelium is weakly attached to the underlying cornea. The causes of this poor adhesion are trauma to the eye via infection, scratch, dry eye, or genetic corneal dystrophies such as epithelial membrane dystrophy, Meesman corneal dystrophy, Reis-Buckler’s corneal dystrophy, lattice dystrophy and more.
Frontal view of a corneal erosion
Signs and Symptoms |
Signs
Red eye, tear in the corneal epithelium, watery eye.
Symptoms
An immediate stabbing sensation upon opening eyes in the morning, light sensitivity, eye twitch, decreased vision, foreign body sensation.
Causes and Risk Factors |
Causes
Poor epithelial adhesion to the underlying cornea.
Risk factors
Dry eyes, trauma, genetic corneal dystrophies.
Prevention and Treatment |
Prevention
Avoid exposure to the causes/risk factors above.
Treatments
· Rolling eyes around underneath lids before opening eyes.
· Cyclopentolate drops for pain.
· Antibiotic drops.
· Bandage contact lens.
· Non-steroidal anti-inflammatory drops or pills.
· Hypertonic eye drops nightly for 3 months.
· Gel drops or ophthalmic ointment.
· Surgery: diamond burr polish, stromal puncture, excimer laser.
Prognosis |
Recurrent corneal erosions can affect quality of life by causing sufferers to become nervous or even scared to open their eyes in the morning. Thankfully, in most situations, recurrent corneal erosions can be easily treated. In some cases, the erosions continue to occur despite best efforts. In these situations, the surgical options can treat 80-90% of cases.
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