Saturday, December 18, 2010

Recurrent Corneal Erosion

Recurrent corneal erosion is an eye condition in which there is a recurrent breakdown of the epithelial cells layer of the cornea. This corneal disorder is characterized by the failure of this outermost layer of the cornea to attach to the underlying Bowman's membrane. In other words, the recurrent corneal erosion is a defective adhesions and recurrent breakdowns of the corneal epithelium. The condition is excruciatingly painful because the loss of these cells results in the exposure of sensitive corneal nerves.

The corneal erosion may be seen by a doctor using the magnification of an ophthalmoscope, although usually fluorescein stain must be applied first and a blue-light used. Opticians, optometrists and ophthalmologists have use of slit lamp microscopes that allow for more thorough evaluation under the higher magnification. Mis-diagnosis of a scratched cornea is fairly common, especially in younger patients. The treatment consists of the use of therapeutic contact lens, controlled puncturing of the surface layer of the eye (Anterior Stromal Puncture) and laser phototherapeutic keratectomy (PTK). These all essentially try to allow the surface epithelium to reestablish with normal binding to the underlying basement membrane, the method chosen depends upon the location and size of the erosion.

Symptoms include recurring attacks of severe acute ocular pain, foreign-body sensation, photophobia, which is the sensitivity to bright lights, and tearing often at the time of awakening or during sleep when the eyelids are rubbed or opened. Signs of the condition include corneal abrasion or localized roughening of the corneal epithelium, sometimes with map-like lines, epithelial dots or microcyts, or fingerprint patterns.