if you have ever woken up in the morning with a lot of pain in one eye
that eye starts to water you might be dealing with a recurrent
corneal erosion and this can happen in people that have had a corneal abrasion
or a scratch in the past or they might be dealing with dry eyes so in this video we're going to go
over exactly what that is why it happens and what the treatment is for it let's focus in
hey howdy this is Dr. Neal Guymon, Dr. EyeGuy, and i actually already released this video but
i got a lot of great comments mentioning a certain treatment that i didn't have in
the video i originally shot that portion of the video but i didn't give that portion to my editor
so it didn't make it in the video so i had to make the hard decision
do i just leave the video maybe mention the treatment in the comments or the description or
take the video down and put it in there i decided to take the video down put it in there because i
just wanted this video to be thorough and helpful so i reshot a couple things and i hope you like it
and thanks for all those people that commented on that video so what is a recurrent corneal erosion
that happens on the cornea the clear dome on the front of the eye where we see through
where people have contacts where they perform lasik and the corny is actually made up of
different layers and those layers are stuck to each other kind of like velcro the top layer the
epithelial layer if that layer comes off because it's not stuck like velcro it exposes the nerves
and the underlying layers which causes the pain and the symptoms now on top of that what stinks
is the new tissue that comes in to replace that might not adhere that well to the layers either
and they're more prone to be ripped off again causing the recurrent nature now the symptoms
of a recurrent corneal erosion can include like i said a lot of ocular pain when you wake up light
sensitivity to the point where light actually hurts the eyes when you're exposed to the light
blurred vision watering and red eyes now why does this happen who is that more risk of getting
a recurrent corneal erosion and we can break this up into three groups the most common group
is definitely people that have had a mechanical trauma to the eye a corneal abrasion either from a
fingernail a foreign body a paper cut tree branch and this accounts for about 45 to 64 of the people
that get these erosions the second group are people with corneal dystrophies right here
now their cornea or their layers of their cornea might not work quite right so they're more prone
to get these erosions and this accounts for about 19 to 29 of the people that get these erosions
the rest of the people fall into a third group that's going to include people with diabetes
but a big one are people that have dry eyes or meibomian gland dysfunction ocular rosacea they
tend to be more prone because the surface of the cornea is really dry to have that erosion happen
a lot of people like to classify recurrent corneal erosions into two different forms microform which
are smaller erosions heal up fast but might happen a little bit more frequently and macro form where
the erosions are much bigger takes longer to heal more symptoms but hopefully doesn't happen
as often so we're breaking up the treatment into two different categories what's the treatment if
you have a current erosion and what the treatment is to prevent an erosion now for a current erosion
first line of defense is your preservative free artificial tears and you want to be using them
a lot every one to two hours now check the description i have a link to the video i made
about my favorite preservative free tiers and i'll put links down there for you as well the
other thing is to use a gel or an ointment at night and this is really important and this is
the part that i didn't get into the other video that there's actually an ointment called miro 128
it's over the counter it's a hyper osmotic agent meaning it's has a high concentration of salt so
it's really good at bringing out water or helping edema or swelling of the cornea and that can
help the layers of the cornea adhere a little bit better so it's really helpful for people that have
recurrent corneal erosions and because it's over the counter i'll put the link in the description
so you can check that out and check out the pricing there and this also could be put in the
preventative category as well a lot of people use miro 128 just to prevent themselves from having
another erosion you also want to make sure that you're drinking plenty of water stay hydrated
now if you have a recurrent coronal erosion you definitely want to go into your eye doctor get the
official diagnosis treatment from your doctor if you're in a lot of pain and you're light sensitive
they may do a few things they may patch your eye they may also dilate your eye with something
called cyclopentylate this will dilate your eyes for a whole day now they may also give you an
antibiotic eye drop more as a preventative thing because you really do have an open wound there so
you don't want that to be infected and they might also give you an anti-inflammatory steroid drop
to help decrease the inflammation that you might be getting from this erosion and then also just
to help with the pain they may tell you to take ibuprofen one other treatment that i definitely
want to mention is your doctor might use a bandage contact lens just like you can wear contacts to
clear your vision you can also wear contacts as a bandage this will help shield your cornea protect
it from the air protect it from your own eyelid it'll make it feel better make it heal faster
and make it heal better and so this is a pretty common treatment that you can use for recurrent
corneal erosions so don't be surprised by that one but this also leads me into what
can be done to prevent recurrent corneal erosions because bandage contact lenses can also be
used to prevent these erosions now if you're someone that really does suffer from recurrent
corneal erosions and it happens quite frequently a bandage contact lens might be a good option there
was a study done where they treated people with recurrent corneal erosions with bandage contact
lenses and they had them wear them for three months and 75 of those patients those people
didn't have a recurrence after that for at least a year another more advanced treatment that i wanted
to mention is the use of amniotic membranes it's an amazing membrane that you can put on
the surface of the eye to heal the eye from many different conditions i actually did a full video
on it if you want to check out the link in the description if you want to learn more but people
can use amniotic membranes for both when you have the erosion currently or to prevent erosions as
well now a lot of the other preventative treatments kind of circle around dry eye
treatments you want to keep the surface of your eye as lubricated as possible one treatment is
puncto plugs you can block the tear drainage holes in the eyelids to keep tears on your eyes longer
i actually did a video about that and i'll also have a video about bandage contact lenses you can
check in the link below and just like preservative free tiers were important during an erosion also
important when you don't have an erosion you want to keep the surface of your eyes as lubricated as
possible preservative-free tears during the day gel at night you can also use moisture chamber
goggles while you're sleeping to keep the moisture around your eyes a whole lot better during the
night and i'll put links in the description if you want to check those out studies have found that
doxycycline and oral antibiotic pill can actually help with meibomian gland dysfunction and dry eye
symptoms also helping with recurrent corneal erosions also restasis it's a prescription eye
drop cyclosporin that helps reduce inflammation helps dry eyes now some people are very unlucky
and have very large recurrent coronal erosions even with trying to prevent them and they're
constantly on treatment using artificial tears and medications and so there are a few surgery options
out there to help with that one surgery is called stromal puncture they actually take a 25 gauge
needle and poke it into the cornea now this sounds barbaric but this actually causes a fibrotic
response and causes scar tissue in those areas where they poke the needle and this actually helps
adhere the layers of the corny a little bit better to reduce the epithelial layer from being ripped
off so it actually works sounds crazy though but it actually works another one is called diamond
bur polishing where they actually take a diamond bur and clean off the epithelial layer so any
areas where they had an abrasion and maybe there's edges where they weren't so clean and flailed off
they'll actually take that diamond bur and clean off those areas and polish it so hopefully it can
make the next new tissue come in and have a better layer to adhere to another surgery is actually
with the laser it's called ptk photo therapeutic keratectomy and they actually use a laser to kind
of do a similar thing like the diamond bur where they're actually going to cut or laser a clear
section of the cornea so it's nice and smooth and clear so the tissue the new tissue coming in has
a better place to adhere to and heal better now one possible complication from recurrent corneal
erosions is haze and scarring where this happens on the cornea and depending on where the scar is
it could cause permanent blurry vision if you have to look through that scar now if you happen to
scratch your corny you'll get a corneal abrasion and you're worried about this definitely check
out my video i did about corneal abrasions right there i'm dr Neal Guymon, Dr. EyeGuy, stay focused