Recurrent corneal erosion syndrome: causes, symptoms and treatment

What is recurrent corneal erosion syndrome?

Recurrent corneal erosion syndrome occurs when the surface layer of the cornea, known as the epithelium, becomes detached from the underlying tissue. This detachment results in intense, stabbing pain that can recur multiple times, typically at night. Although episodes may subside, they often reoccur, leading to considerable distress and disruption in daily activities.

What causes recurrent corneal erosion syndrome?

Several factors can trigger recurrent corneal erosion:

• Injury: A scratch or trauma to the cornea, such as from a child’s fingernail or accidental injury while gardening, can lead to recurrent erosion.
• Spontaneous occurrence: In some cases, the condition develops without any known injury. This can be linked to underlying issues with how the layers of the cornea adhere to each other, often associated with a condition known as epithelial basement membrane dystrophy.
• Abnormal adhesion: In individuals with epithelial basement membrane dystrophy, the normal adhesion between the corneal layers is disrupted, making the cornea more susceptible to recurrent erosions.

What are the treatment options for recurrent corneal erosion?

Medical Treatments

• Lubricating ointments: The most common initial treatment involves applying lubricating ointments at night. This helps to keep the corneal surface lubricated and prevents it from sticking to the eyelid during sleep, thereby reducing the likelihood of erosion. This method may need to be continued for several months.
• Salt ointments: Your eye doctor may recommend using salt ointments at night to draw moisture out of the cornea and alleviate symptoms.
• Hydration and lid margin care: Staying well-hydrated and managing lid margin conditions, such as blepharitis and meibomian gland dysfunction, can also be beneficial in managing recurrent corneal erosion.

Surgical Treatments

If conservative treatments like lubricating ointments fail, more advanced surgical options are available:

• Needle puncture or alcohol delamination: These procedures involve creating small punctures in the cornea or using alcohol to remove the damaged surface layer. While these methods can be effective, they are less commonly used than laser treatments.
• Laser PTK (Photo-Therapeutic Keratectomy): At OCL Vision, our preferred treatment is laser PTK. This technique uses an excimer laser to remove the damaged surface cells and stimulate better adhesion of the corneal layers. PTK is successful in stopping recurrent corneal erosion in 80-90% of cases. If necessary, the procedure can be repeated.

To learn more about our surgical procedures and how they can help you, please explore our dedicated pages here.