I have a very painful and frustrating problem that neither I nor my ophthalmologist seem able to resolve. The problem involves recurring corneal abrasions.
Back in December of '89 the corneas of both my eyes became scratched on two different occasions. I don't recall anything ever coming into contact with the eyes during the day, and my opthalmologist could find no evidence of a foreign body. He suggested that I may have scratched my eyes with a finger nail, pillow case zipper or edge of a bed sheet while I was asleep. He prescribed an ointment containing steroid (administer before going to bed) and some drops (4 times per day).
The pain disappeared after about a week, and vision seemed to return to normal in about 3 weeks (no blurring or light diffraction).
The abrasions returned in both eyes in the same place about a month and half later. Again I returned to my doctor and he verified that these were the same abrasions reopening. He could not explain why they recurred, other than "sometimes it takes a long time to heal and the new cells periodically will erode, reopening the wound."
Again, both eyes healed within a couple of weeks.
Three days ago, my right eye again abraded with the associated intense pain. I met my doctor in the emergency room where he verified that it was the same old abrasion, but larger in size than the last time - about 15 millimeters. He still can offer no explanation as to why the situation keeps repeating itself.
I am fearing for my long term vision and getting desperate about this situation. I consider my doctor to be a competent, knowledgable and sensitive person, but I wonder if he's missing something crucial. It's difficult to go through life periodically feeling like there's a knife in your eye. What causes these incidents to repeat themselves and is it time to go for a second opinion? Thanks in advance.
Answered by Richard E. Gans, M. D.
Your situation is typical of a condition called "recurrent erosion syndrome." In this situation, defects in the surface layer of cells in the cornea will slough off because of a lack of adherence to underlying cells. Typically, this occurs upon awakening in the morning when you first open your eyes, but it can occur at any time. Several conditions predispose an individual to develop recurrent erosions. A previous injury can be one. In addition, there are several corneal dystrophies, congenital problems with the cornea, which do not become symptomatic until adulthood, which can result in frequent recurrent erosions.
There are a variety of modalities of treatment for recurrent erosion syndrome. When an erosion is present, the typical treatment involves patching the effected eye until the defect heals, usually within 24-48 hours. After the erosion heals, treatment is directed toward prevention of new erosions. This is achieved with either ocular lubricants, hypertonic (osmotic) agents, or bandage contact lenses. If these methods fail, there are surgical options to correct the problem which may be effective.
Recurrent erosion syndrome is a frustrating problem in that treatment must sometimes be continued for several months or longer. Although the erosions are painful and disabling, they are unlikely to cause significant long-term visual loss.
PLEASE NOTE: The information contained on this system is not intended to supplant individual professional consultation, but is offered as a community education service. Advice on individual problems should be obtained directly from a professional.
Copyright, 1994. Richard E. Gans, M.D.
Last Modified: August 23, 1996