Recurrent Corneal Erosion

What is recurrent corneal erosion?

Recurrent corneal erosion occurs when the outermost layer of the cornea does not attach firmly to the tissue beneath it. The surface can repeatedly break down, causing sudden episodes of eye pain. Symptoms often occur during the night or first thing in the morning when the eyelid opens and pulls on the fragile corneal surface.

What causes recurrent corneal erosion?

A common cause is a previous corneal scratch, sometimes months or years earlier. Recurrent erosion can also occur with epithelial basement membrane dystrophy and other conditions that affect how the surface cells adhere to the cornea.

Symptoms

• Sudden sharp eye pain, commonly on waking
• Watering
• Light sensitivity
• Blurred vision
• Foreign-body sensation
• Redness
• Repeated episodes in the same eye

How is recurrent corneal erosion diagnosed?

An ophthalmologist examines the corneal surface with a slit lamp, often using fluorescein dye. The eye may look almost normal between episodes, so a history of repeated pain on waking is an important clue. Your specialist will also look for an underlying corneal dystrophy or other surface disorder.

Treatment for an acute episode

Treatment aims to allow the surface to heal, relieve pain and reduce the risk of infection. Depending on the severity, this may include lubricating drops or ointment, antibiotic medication, pain relief and, in selected cases, a bandage contact lens. Anaesthetic eye drops used during examination are not intended for repeated home use because they can delay corneal healing.

Preventing further erosions

Regular lubrication is often recommended for several months after an episode. A thicker ointment at night may reduce friction between the eyelid and the cornea. Hypertonic saline may also be used in selected cases.

What if the erosions keep returning?

If frequent episodes continue despite regular lubrication, your ophthalmologist may discuss additional treatment. Options can include a longer-term bandage lens or a procedure to improve the attachment of the surface layer. Phototherapeutic keratectomy (PTK) is one laser option used in selected patients, particularly when an underlying superficial corneal abnormality is present.

Seek prompt review if symptoms change

A recurrent erosion can feel similar to a new corneal infection. Seek prompt assessment if pain or redness is worsening, vision is significantly reduced, there is discharge, or the eye is not improving as expected.