Corneal Erosion

Recurrent corneal erosion is a condition characterized by the failure of the cornea’s epithelial cells to attach to the underlying basement membrane (Bowman’s layer). The condition is excruciatingly painful because the loss of these cells results in the exposure of sensitive corneal nerves.

Symptoms include recurring attacks of severe ocular pain, feeling like there’s something in your eye, photophobia (i.e. sensitivity to bright lights), and tearing often at the time of awakening or during sleep when the eyelids are rubbed or opened.

Signs of the condition include corneal abrasion or localized roughening of the corneal epithelium, sometimes with map-like lines, epithelial dots or microcysts, or fingerprint patterns. An epithelial defect may be present, usually in the inferior interpalpebral zone.

Treatment includes copious lubrication and ointment.  Muro 128 5% ointment works very well.  I have also used bandage contact lenses to help manage corneal erosions.

Surgical options include anterior stromal puncture (a procedure where tiny holes are made in the top layer of the cornea, which promote a more secure attachment to the layers underneath it), superficial keratectomy (a procedure that removes malfunctioning surface cells from the cornea), and phototherapeutic keratectomy (or PTK, a laser surgery that removes scar tissue and irregularities from the corneal surface).