Recurrent corneal erosion overview
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Recurrent Corneal Erosion Microchapters |
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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
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. [2]
Physical Examination
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.
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
Alternatively, under local anaesthetic, the corneal layer may be gently removed with a fine needle, cauterised (heat or laser) or 'spot welding' attempted (again with lasers). The procedures are not guaranteed to work, and in a minority may exacerbate the problem.