Recurrent Corneal Erosion: severe eye pain upon awakening

Recurrent corneal erosions, also known as recurrent erosion syndrome (RES), is a disorder of the epithelial cells that line the surface of the cornea. It is a chronic, relapsing disorder which results in periodic episodes of exquisitely painful epithelial erosions. Oftentimes these corneal erosions result in such severe symptoms that patients are unable to work or perform routine daily activities.

The two main risk factors for developing recurrent corneal erosions are a previous abrasion to the eye or a pre-existing epithelial basement membrane dystrophy that predisposes the cornea to erosions. In either case, the epithelium that lines the surface of the cornea is loosely adherent to the underlying corneal tissue. When the eye dries out (as it typically does overnight), the loose epithelial cells stick to the inner upper lid. When the eye opens, it rips the loose skin or epithelial cells from the cornea, leaving a painful abrasion. Many people who suffer from recurrent corneal erosions have episodes first thing in the morning when they first open their eyes. Episodes of pain can last a few hours to days depending on the severity of the abrasion.

There are numerous modalities to treat RES. Medical management includes using artificial tears to promote lubrication, hyperosmotic drops, ointments, or bandage contact lenses. Surgical management of RES includes office procedures such as epithelial debridement where the abnormal surface cells are removed allowing new, healthy cells to take their place. Anterior stromal puncture (ASP) is another procedure that can be done in the office. Here, small punctures are made over the area of unhealthy epithelium to promote scarring and adhesion of the epithelium to the underlying corneal tissue. Finally, phototherapeutic keratectomy or PTK is another surgical modality available to treat RES. Here, a laser is used to treat the area of unhealthy epithelium and promote better adhesion to the underlying corneal tissue.

Here at North Shore Eye Care, a division of SightMD, we have the laser required to perform PTK right here on the premises. If you would like to be evaluated for RES, call one of our offices today. We are conveniently located in Queens and across long island in both Nassau and Suffolk Counties.

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