My Eye Hurts, REALLY BAD!!
Have you ever woken up in the morning and opened your eyes and BOOM, you feel a stinging shooting pain in your eye? Now, this is more than just irritated eyes, crustiness or “sleep” in your eyes. This is a stabbing pain that makes you borderline non-functional. The former description of milder symptoms is either from an incomplete lid closure, a fan blowing on you at night, or perhaps the seeping of air from an ill fitting CPAP machine. The latter is a chronic condition known as recurrent corneal erosion (RCE).
Recurrent Corneal Erosion
If you know, you know. A recurrent corneal erosion is a debilitating experience that can strike at any time, but usually occurs when you first wake up. I typically see it in patients 30-50 years old, but I have seen it in patients as old as 90. These patients usually have a related condition such as dry eye, diabetes, or ocular rosacea.
A History of Trauma
Why does this happen? In the simplest terms, the outermost layer of the cornea (the clear windshield of the eye) becomes unstable and gets scraped off rather easily. This is usually because of a chronic condition that causes the outer layer to become less sticky (epithelial basement membrane dystrophy) or more commonly some kind of superficial trauma to the eye in the patient’s past. For example: getting poked in the eye, history of LASIK, or even something as common as cataract surgery.
Treatment
You know that something is not right the moment you wake up. It will not go away and patients usually have red, watery eyes, with pretty extreme light sensitivity. In an acute occurrence, I generally prescribe an antibiotic to prevent infection, put in a drop to help with light sensitivity and pain, and may put on a bandage contact lens to increase healing and stop discomfort. The bandage contact lens provides a barrier from the eyelids when a patient blinks. Preservative free artificial tears and oral analgesics such as Tylenol or ibuprofen will help with the pain.
Next Steps
This is the foundation of treatment. Unfortunately, this condition is chronic, recurring, and can be very traumatic physically and psychologically if you cannot predict when it is going to happen. However, there is still hope! Check out our other blogs to learn about treating underlying conditions and the most advanced therapies to prevent recurrence. To be seen for a dry eye evaluation, give our office a call or click here to schedule.