Recurrent Corneal Erosion: Its Causes, Symptoms And Treatment

Recurrent Corneal Erosion: Its Causes, Symptoms And Treatment . Recurrent corneal erosion is a painful condition of eye that affects the outermost layer of the eye, called cornea. Cornea is made up of three layers; the innermost is called endothelium, the middle part which makes the maximum of cornea is called the stroma. The outermost is the epithelial layer.

Recurrent corneal erosion involves this outermost epithelial layer of the cornea. Problem arises when the epithelial cells fail to attach themselves to underlying layer, known as Bowman’s layer. Due to poor adherence they peel off easily. This gives rise to excruciating pain because, without the protective epithelial layer, the corneal nerves are completely exposed.

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Usually there is an underlying triggering factor which is responsible for this ocular malady. It is often seen in adults who have crossed forty years.

What Causes Recurrent Corneal Erosion?

Recurrent corneal erosion in most cases is an acquired condition. However in some people, it can be an inherited problem. It occurs after the fourth decade of life, affecting equally men and women. Often both the eyes are involved.

• The commonest cause is superficial corneal trauma. Especially when the abrasion is clean cut rather than a rough one. Abrasion may be from the fingernail, contact lens, foreign body, alkali burns, hair brush, branches of tree, or even dust.
  
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   The condition develops after a week or ten days after the first injury. But sometimes it can also develop after several months.
• Dry eye syndrome, corneal dystrophy and keratopathy are other causes that can trigger REC (recurrent erosion cornea).
• After ocular surgeries such as cataract surgery or refractory surgery, vitrectomy.
• Diabetes, nutritional deficiencies, other rare hereditary disorders are predisposing factors for precipitating the condition.
• Few medications such as Thiomersal which is found in many eye drops and even is contact lens solution and topical neomycin ointment are also precipitating factors for recurrent corneal erosion.
• Rarely the condition is known to be inherited.

Symptoms Of Corneal Erosion

The condition in most cases affects both the eyes; this depends on the underlying cause. In its early stage, there may not be any symptoms but later on there may be repeated episodes of pain in the eyes when the patient wakes up in the morning.

When seen through an ophthalmoscope (an instrument used to see the eyes by doctors), there appears parallel lines and dots that may look similar to fingerprint or a map on the corneal epithelium.

As the name suggests, there are repeated episodes of corneal erosion even if there is complete healing.

The characteristic signs and symptoms are:

• Excruciating pain in the eye. Especially when the patient gets up after sleep.
• Blurring of vision.
• Sensation of foreign body in the eye.
• Redness.
• Excessive flow of tears.
• Eye become irritated when they dry.
• Sensitive to bright light. Patient finds difficulty going out in sunlight.
• Spasm of the muscles around the eye.

Treatment For Recurrent Corneal Erosion

Here are some of the self care tips that are useful.

• Do not rub the eyes.
• Wear goggles to reduce the sensitivity of sunlight or any bright light.
• Wash your eyes with clean water.
• Do not wear contact lens if there is any problem in the eyes. You should remove them immediately if there is any pain or irritation in the eyes.
• Use artificial tear drops to keep your eyes well lubricated.
• Avoid dry atmosphere.
• Avoid cigarette smoke or any smoke for that matter which irritates the eyes.

In most cases the condition heals completely after an appropriate treatment.

Saline solution is generally prescribed by the doctor in the beginning. It helps in proper adherence of epithelial layer to the Bowman’s layer of cornea.

In case of corneal dystrophy, the ophthalmologist does some procedures to encourage the epithelium to bond itself to the Bowman’s layer.

Photo therapeutic Keratectomy is the last resort if all other treatment methods fail. Here the superficial cells of the cornea are removed gently with laser. This method encourages proper healing.