Recurrent Corneal Erosion

What is the cornea?

The cornea is the clear front window of the eye. It covers the coloured portion of the eye, much like a watch crystal covers the face of a watch. The outermost layer of the cornea is called the corneal epithelium.

What is a corneal erosion or abrasion?

A corneal erosion or abrasion refers to a scratch or injury of the corneal epithelium. The epithelium is the very thin skin-like superficial layer at the cornea. These painful abrasions occur quite commonly from contact lenses, a baby's fingernail, tree limbs, bushes, or vigorous rubbing of the eye. Recurrent corneal erosion may be precipitated by a recent or distant corneal abrasion. Some people have a hereditary weakness of adhesion of the corneal epithelium to an underlying corneal dystrophy. This may result in a spontaneous corneal erosion often occurring upon awakening in the morning when tears have dried out and friction may be present between the underside of the eyelid and the corneal surface.

How is this condition treated?

The most common treatments are either lubricating ointment or a bandage contact lens at bedtime. This protects and allows the damaged epithelium to heal, and also reduces the pain by preventing the eyelid from irritating the affected area.

Occasionally, long after an abrasion has healed, it recurs spontaneously, often upon awakening in the morning, requiring the use of ointments at bedtime.

Lubricating ointment is used every night at bedtime and provides a thin layer of protection between the upper eyelid and the corneal surface that should last until awakening in the morning. The most commonly used ointments are Muro 128, Lacrilube or Duolube. All can be obtained over-the-counter without prescription from the pharmacy.

A contact lens, similar to ointment, provides a physical barrier between the lid and cornea. It may be used for days, weeks, or months and is generally replaced every two weeks.

If the above measures are ineffective, then an office procedure named corneal micropuncture or a corneal laser treatment are the next steps