Cornea

Recurrent Corneal Erosions (RCE)

Overview

Recurrent corneal erosion is a condition affecting the outermost layer of corneal cells called the epithelium. This problem is caused when the bottom layer of epithelial cells are attached poorly to the underlying corneal layer, causing them to slough off easily. Pain and discomfort are quite intense, similar to a corneal abrasion. There is usually an underlying disorder that causes recurrent corneal erosions. 

Symptoms

Symptoms of RCE may include:

  • Severe pain (especially after awakening)

  • Blurred vision

  • Foreign body sensation

  • Dryness and irritation

  • Tearing

  • Red eye

  • Light sensitivity

Risk Factors

People at risk for RCE include:

  • Previous corneal injury (corneal abrasion) 

  • Corneal dystrophy such as Map-Dot-Fingerprint Dystrophy

  • Corneal disease resulting in recurrent breakdown of the epithelial cells

  • Previous corneal surgery or procedure​

 

Upon awakening from sleeping, patients often experience severe pain, blurred vision, and light sensitivity when the eyelid pulls the loosened epithelial cells off the cornea. After the cornea heals, the problem recurs unless the condition is properly treated. Recurrent corneal erosion may affect one or both eyes, depending on the underlying cause.

Treatment

Sodium Chloride eye drops and ointments are usually prescribed as the first line of treatment. These medications help the epithelium to adhere better to Bowman's layer of the cornea. Sometimes, a soft or bandage-type contact lens is used to facilitate healing. Artificial tears are also recommended to keep the cornea moist.

Those with underlying corneal dystrophy or patients who failed to improve with conservative non-invasive treatments may need an in-office surgery called anterior stromal puncture (ASP). In this procedure, deep microscopic punctures are made with a needle on the surface of the cornea to encourage epithelial cells to bond securely to Bowman's layer underneath.

Patients who continue to suffer from RCE despite above standard treatments, may benefit from phototherapeutic keratectomy (PTK). This involves removal of the outer layer of corneal cells using the Excimer laser to encourage proper healing.

Dr. Kim is a corneal specialist who has successfully treated numerous RCE patients. Call our office to schedule an appointment with Dr. Kim if you suffer from RCE or symptoms encountered in RCE.

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