Summary about Disease
Recurrent Corneal Erosion Syndrome (RCE) is a condition characterized by the repeated breakdown of the corneal epithelium, the outermost layer of the cornea. This breakdown typically occurs spontaneously, often upon waking, and causes sudden, sharp eye pain. It's a chronic condition with periods of remission and exacerbation.
Symptoms
Sudden, sharp eye pain, often upon waking or opening the eyes.
A gritty sensation, as if something is in the eye.
Excessive tearing.
Light sensitivity (photophobia).
Blurred vision.
Redness of the eye.
Feeling of a foreign body in the eye
Causes
Corneal Trauma: The most common cause is a previous corneal injury, such as an abrasion from a fingernail, contact lens, or other object.
Corneal Dystrophies: Some inherited corneal conditions, such as epithelial basement membrane dystrophy (EBMD), also known as map-dot-fingerprint dystrophy, can predispose individuals to RCE.
Dry Eye Syndrome: Insufficient tear production can contribute to RCE.
Other Corneal Conditions: Conditions that affect the structure of the cornea can increase the risk.
Age
Medicine Used
Artificial Tears: Lubricating eye drops used frequently throughout the day to keep the cornea moist.
Ointments: Lubricating ointments applied at bedtime to prevent the eyelids from sticking to the cornea overnight.
Hypertonic Saline Drops or Ointments: Help to draw fluid out of the cornea and promote adhesion of the epithelium.
Topical Antibiotics: Used to prevent infection, especially after an erosion.
Topical Corticosteroids: Used in some cases to reduce inflammation, but must be used with caution due to potential side effects.
Bandage Contact Lens: A soft contact lens used to protect the cornea and promote healing.
Stromal Puncture: A procedure to create small punctures in Bowman's layer to promote better adhesion of the epithelium.
Anterior Stromal Micropuncture: Similar to stromal puncture, but uses a finer needle.
Phototherapeutic Keratectomy (PTK): A laser procedure to smooth the corneal surface and improve epithelial adhesion.
Diamond Burr Polishing: A procedure to remove loose or irregular epithelial cells and promote healing.
Is Communicable
No, recurrent corneal erosion is not a communicable disease. It cannot be spread from person to person.
Precautions
Lubricate frequently: Use artificial tears throughout the day, especially before activities that might irritate the eye.
Use lubricating ointment at night: Apply a thick lubricating ointment before bedtime to prevent the eyelids from sticking to the cornea.
Avoid rubbing your eyes: Rubbing can disrupt the healing process and trigger an erosion.
Protect your eyes: Wear safety glasses or goggles during activities that could cause corneal injury.
Manage dry eye: If you have dry eye, follow your doctor's recommendations for treatment.
Humidify your environment: Using a humidifier, especially in the bedroom, can help keep the eyes moist.
Follow doctor's instructions: Adhere to the prescribed medication and follow-up schedule.
How long does an outbreak last?
The duration of an RCE outbreak can vary significantly from person to person. An acute episode of pain and discomfort can last from a few hours to several days. The frequency of these episodes also varies; some individuals may experience them weekly, while others have longer periods of remission.
How is it diagnosed?
Medical History: The doctor will ask about any previous eye injuries or other relevant medical conditions.
Slit-Lamp Examination: A slit lamp is a microscope used to examine the cornea. The doctor will look for signs of epithelial defects or loose epithelium.
Fluorescein Staining: A yellow dye (fluorescein) is applied to the eye, which highlights areas of epithelial damage under a blue light.
Eversion of Eyelid: The doctor may evert the eyelid to check for any foreign bodies or abnormalities.
Timeline of Symptoms
Initial Event (Often Trauma): An initial corneal abrasion or injury may occur.
Healing Period: The initial injury heals, but the adhesion of the epithelium may be weak.
Latency Period: A period of time, ranging from weeks to months, where there are no symptoms.
Recurrent Erosion: Sudden onset of sharp pain, often upon waking, due to epithelial breakdown.
Acute Phase: Pain, tearing, light sensitivity, and blurred vision lasting hours to days.
Recovery Phase: Gradual improvement of symptoms with treatment.
Remission/Exacerbation: The condition may cycle through periods of remission (no symptoms) and exacerbation (recurrent erosions).
Important Considerations
Chronic Condition: RCE is often a chronic condition that requires ongoing management.
Individualized Treatment: Treatment plans are tailored to the individual patient and the severity of their symptoms.
Compliance: Following the doctor's instructions and being consistent with lubrication is crucial for managing the condition.
Potential Complications: Although rare, complications such as infection and corneal scarring can occur.
Second Opinion: If symptoms are not improving with treatment, seeking a second opinion from another ophthalmologist may be beneficial.
Contact Lens Wear: People that use contact lenses should follow eye care professionals instructions concerning how to wear them, clean them and what to do if there are any symptoms that happen.