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after corneal abrasion, will I ever be able to wear contacts again?

I had a corneal abrasion, (fingernail in eye) immediately visited the optometrist who prescribed antibiotics, steroid drops, and no contact wear. After followup 4 days later, the drops were tapered off and I was cleared to wear contacts in a few days (7 days after injury). I could somewhat verify the progression of healing at home; the vertical light on my makeup mirror reflected on my cornea - the reflection was smooth expect for the injury, where the reflection rippled. After a week, the whole area was smooth again. I waited 10 days instead of the recommended 7 and inserted my RGP contacts for a few hours without issue. However on the 11th day, I blinked while inserting the contacts and it did not go in right, the edge of the lens must have bumped the injury and removed some cells. I didn't experience pain at this time and wouldn't describe the lens as having poked my eye, but I could see the corneal surface was disrupted since the vertical reflection of the mirror light on my cornea was again rippled where the injury was. I returned to the optometrist who seemed a bit perplexed this happened, and they noticed some very tiny recurrences of abrasion, and noted that the surface indeed wasn't smooth anymore. I have a followup in two days, at which time the optometrist thinks it's likely I can return to contact lens wear - but I am concerned this issue will happen again if the edge of the contact bumps the abrasion healing area. My question is, should I wait longer for the cells to solidify/strengthen beyond what my optometrist is recommending, or, is it possible I'll never be able to wear RGP lenses again? The optometrist did not mention if there was damage to the Bowman's layer. A second question is, given that the optometrist seemed a bit surprised by the issue, would I benefit from visiting a corneal specialist?
1 Responses
177275 tn?1511755244
There is no way to generalize about your problem.  As a generalization the cornea takes about 6-8 weeks to heal as strong as normal. Sometimes longer; sometimes it doesn't heal well and small bit of the cornea are ripped off especially during sleep. This is called recurrent corneal erosion syndrome.  Read about it on the internet.  Also about 20% of our LASIK/SMLE  refractive surgery are because people lose the ability to wear their contacts.  If you have access to an ophthalmologist that specializes in the cornea that would be ideal.
3 Comments
In re-reading the above answer the first and second sentences are not contradictory.  All these injuries are somewhat different (first sentence). Second sentence refers to time for cornea to form the anchors (hemidesmosomes) that hold the surface (epithelium) on and make it as strong as normal.
Thanks for your reply, I did visit a corneal specialist who agreed I probably should take a break from contacts for a good while to assure everything is healed better, put me on a lubrication regimen, and that RGP may not work as they sit on the cornea, but he told me about scleral lenses that sit above the cornea and can also actually contribute to further healing as it keeps the cornea very moist and protects it from the eyelid. Time will tell if I need other treatment to heal the RCE
RCE very difficult to get healed. Use a lubricating gel or ointment at bedtime, rinse with warm water when get up, and put in regular artificial tears, don't sleep under fan or have air blowing in your face (e.g. car heater vent). I tell my patients do that for 6 months with no flare up of RCE before you consider stopping meds.
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177275 tn?1511755244
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