Recurrent Corneal Abrasions... Im misserable.

[AshleyH30]

  So 2 weeks ago with out warning or knowing I got some thing in my eye suddenly it started burning, tearing constantly, irritated and i barely could keep it open... it got worse and lasted almost 2 days, it felt like some thing was constantly in it and it continued to be irritated, I finally went to my doctors when my vision got blurry in that eye. I had an abrasion that covered my whole cornea. I saw an eye doctor who gave me drops for it and after 9 days it was clearing up, I was taken out of work for it and couldnt drive because the blurriness. I was ready to go back to work monday, but woke up sunday morning with the same eye completely blurry again... then 2 hrs later my eye was tearing, irritated and ect. Like it happend all over again! So I went right to my doctor that sunday and she checked it, I had nothing visable she could see with the dye and blacklight... so she took me out of work and told me to see my eye dr first thing monday, when I saw her she told me my eye was completely covered with a new but much bigger abrasion. She has never seen this happen and not re occuring in the same area as the 1st time. So im still out of work and going to see a corneal specialist in 4 days.
    Ive slept with my eyes slightly open since I was in my teens, but now im 30... does that effect how my eye is healing from the start of these issues? What are they going to do when I see the specialist?  Ive never had eye problems ever, so ive researched it some what but Im scared my vision will be effected long term or it may be something worse thats happening to my eye.

[John C Hagan III, MD, FACS, FAAO]

Zylet is a combination antibiotic and steroid. If you are treating for recurrent corneal erosions then using lubricating drops/Muro 128 and Muro 128 ointment at bedtime is useful. You should probably check with the corneal surgeon and confirm you have RCE and ask about Muro 128 drops and ointment
JCHMD

[AshleyH30]

Thanks. Although they said they are unsure what this is. My vision is less than half of what my other eye is currently and had not gotten any better. The specialist I saw said this will take a lot of time to go away and that I have fuzzy spots with scratches over that then some cysts on top of those that are causing my vision issues. I got put on zylet eye drops and have to return in 2 weeks to see if any changes took place or I need to return to Flaum Eye Institute in Rochester ny if anything gets worse. When I wake up my vision is pretty good but with in half hr it's back to bad, it's so strange. So I'm still out of work. I drive clients around during my day so I can't be responsible for them with this vision loss currently. It *****. i appreciate your help ;)

[John C Hagan III, MD, FACS, FAAO]

You have "recurrent corneal erosion syndrome". The condition is common and will not destroy your sight or cause serious loss of vision. It has been discussed in the past in the eye care forums. It usually starts after a scratched cornea that does not heal properly. In some instances it occurs due to a common disease of the outer layer of the cornea (basement membrane disorder). Use the search feature and type in "corneal erosions".

Here is part of a recent post on the problem:

Recurrent corneal erosions are the bane of the practice of ophthalmology for both the ophthalmologist (Eye MD) and the poor patient. I saw 2 of them in the office today. They can be very difficult and recalcitrant to treat. Not infrequently they are controlled with drops and ointments but reoccur if these medications are stopped. I'm sure you're well versed on the medical and preventive treatment of corneal erosions.

Treatment is to avoid anything that dries the eye. So keep it moist with artificial tears. At bedtime a lubricating drop with normal saline (Muro 128 ointment---available over the counter) is put in the eye.  Extreme care must be used in the morning on awakening as this is when the tissue usually tears. Avoid rubbing the eye. If the eye wants to stay shut from the ointment leave it shut, splash with warm water till it opens then put in an artificial tear or Muro 128 DROPS (available as 2% or 5% [which often stings] also available over the counter. If Muro 128 products are irritation try Refresh-PM ointment at bedtime and a good artificial tear on awakening and several times during the day (Systane, Opteve, Soothe, Refresh, Tears Naturale, etc).

Long plane and car trips are very stressing for corneal erosions. In the car, run the air conditioner or heater on the feet vents not into the face. Put artificial tears in the eye every couple of hours on a car trip and every hour on a plane trip.

You should go a minimum of 4 months without any pain from the erosion (usually during sleep or upon wakening) before trying to stop the ointment. Be aware that some people are never able to stop the medications and must use drops, ointments and precautions indefinitely (years and years).

The next step is often corneal stromal micro-punctures. This is an office procedure done with just eye drop anesthesia; a bandage contact lens is put in the eye for several days. You may return to normal physical activities immediately.  

If the problem persists then you may need to discuss these treatments with your ophthalmologist. He/she should be able to do the first method. The second he/she may or may not be able to do, sometimes referral to a cornea specialist is indicated.

1. There is a new method of treatment when all else fails. It involves taking oral tetracycline for a couple of weeks coupled with steroid eye drops. If your ophthalmologist is not familiar with the method he/she can do a literature search of the medical ophthalmology journals. The first time I read of it was in the journal "Ophthalmology". I have used this method on two patients that were "at their wits end and had tried everything else. In both cases it worked. I still have them use an ointment at bedtime such as Muro 128 or Genteal Gel but the severe pain has stopped.

2. The last technique would be to use the eximer laser to "resurface" the corneal epithelium and soft contact lens wear during the healing. This technique is most often used when the cornea has disease that keeps causing the erosions, the most common of these is corneal epithelial basement membrane disorder.

Keep trying and good luck.

[John C Hagan III, MD, FACS, FAAO]

Use the search feature and archives. I have written extensively about treatment of Recurrent corneal erosions.

JCH MD