Recurrent corneal erosion overview
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Differentiating Recurrent Corneal Erosion from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]
Overview
Recurrent corneal erosion is a disorder of the eyes characterized by the failure of the cornea's outermost layer of epithelial cells to attach to the underlying basement membrane (Bowman's layer). The condition is frequently painful because the loss of these cells results in the exposure of sensitive corneal nerves.
Causes
There is often a history of previous corneal injury (corneal abrasion or ulcer), but also may be due to corneal dystrophy or corneal disease. In other words, one may suffer from corneal erosions as a result of another disorder, such as map dot fingerprint disease. [1]
Diagnosis
History and Symptoms
Symptoms include recurring attacks of acute ocular pain, foreign-body sensation, photophobia (i.e. sensitivity to bright lights), and tearing often at the time of awakening or during sleep when the eyelids are rubbed or opened.
Physical Examination
Signs of the condition include corneal abrasion or localized roughening of the corneal epithelium, sometimes with map-like lines, epithelial dots or microcysts, or fingerprint patterns.
Other Diagnostic Studies
The 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.
Treatment
Surgery
Where episodes frequently occur, or there is an underlying disorder, different types of curative procedures may be attempted:[2] use of therapeutic contact lens, controlled puncturing of the surface layer of the eye (anterior stromal puncture) and laser phototherapeutic keratectomy (PTK).[3] 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.
References
- ↑ Review of Ophthalmology, Friedman NJ, Kaiser PK, Trattler WB, Elsevier Saunders, 2005, p. 221
- ↑ Liu C, Buckley R (1996). "The role of the therapeutic contact lens in the management of recurrent corneal erosions: a review of treatment strategies". CLAO J. 22 (1): 79–82. PMID 8835075.
- ↑ Indiana University Department of Ophthalmology - Phototherapeutic Keratectomy (PTK)