A recurrent corneal erosion is a debilitating condition that affects patients of all ages. It most commonly occurs upon awakening and causes redness, pain, tearing and extreme photophobia. The most common reason for this occurrence is a past trauma to the eye. For example, getting poked or scratched, having a history of LASIK surgery, or even cataract surgery would be considered trauma. Conditions such as diabetes, ocular rosacea, or blepharitis can also delay the healing process.
What can prevent this from happening?
Once you have had trauma to the eye, you are at increased risk for recurrent corneal erosion. As the name implies these are recurrent in nature and if you have one, the area will become more and more prone to future defects and issues.
After the abrasion is healed, our job is to do everything we can to keep the outer layer of the cornea attached. The use of hypertonic drops (salt drops – called Muro 128) during the day and hypertonic ointments (salt based ointment – Muro 128) creates a gradient that will suck the water out of the tissue and “suction” it to the cornea.
In addition to the salt drops and ointment, treating the underlying related conditions such as dry eye, blepharitis, and ocular rosacea are paramount. Dry eye disease can have a variety of causes, but it stems from an unstable tear film. An unstable tear film means all the ingredients of a healthy tear film are there but in the wrong amounts. The hypertonic drops/ointment can make this worse! As you can see, there is a delicate balance to treating the erosion and not making the underlying condition worse.
Blepharitis and ocular rosacea go hand in hand and both cause dry eye disease. There are a variety of treatments (such as lid scrubs with a tea tree foam cleanser and the use of hypochlorous acid spray) to kill bacteria and reduce inflammation. Intense pulse light (IPL) therapy, ZEST advanced lid cleaning, and TearCare targeted eyelid heat therapy are also used to open up and restore function of the eyelid glands.
In cases that are slow to heal or in patients that have frequent recurrences, a referral for certain surgical procedures may be required. These have varying degrees of success and like any surgical procedure, it comes with a certain level of risk. However, there are two new therapies that should be considered: Autologous Serum Eye Drops and Amniotic Membranes.
Autologous Serum and Amniotic Membranes
Autologous serum is one of the most amazing treatments in ocular surface disease. These are “super” artificial tears. Despite how far artificial tear technology has come, we have not been able to re-create artificial tears that are exactly like our own tears. That is where autologous serum bridges the gap. Blood is drawn, the solid components are removed, and the liquid is made into eye drops. These are loaded with growth and healing factors that help the corneal surface heal and regenerate.
Much like autologous serum, amniotic membranes are loaded with growth and healing factors that help the corneal surface regenerate. These membranes are donated by mothers who have healthy, planned cesarean sections. These small disc-like structures are placed on a contact lens and left on the eye for 3-5 days. Once the disc has dissolved, the contact lens is removed and the cornea is restored.
Both of these are reserved for severely compromised corneas or in patients who suffer from chronic recurrent corneal erosions. If this is you, it is definitely worth discussing these options with your eye care provider. If they are not up to date on these treatments, I advise finding an office that specializes in dry eye and ocular surface disease. To schedule a consultation with us, click here!