Recurrent corneal erosion with blurred vision?
Hello, Doctor.
In early December, I woke up suddenly feeling a sharp pain in my eye.
I went to a local hospital and was diagnosed with a corneal abrasion.
After using eye drops and ointment for a week, the pain subsided.
I then went to a larger hospital for a follow-up examination, where the doctor said it hadn't healed properly and that my cornea appeared wrinkled.
They decided to debride the area to allow the cornea to heal properly.
After another week of using eye drops and ointment, I returned for a follow-up and was told it had healed, but I needed a month for the cornea to fully recover and strengthen.
However, over the next two months, I occasionally woke up with sharp pain and tearing in my eye.
Today, I noticed that my right eye's vision has become very blurry; even with glasses, I can't clearly see the text on my phone or keyboard.
I visited a different clinic, and the doctor said that repeated abrasions can occur after an injury and prescribed more eye drops and ointment.
I have a few questions:
1.
Is it normal to have such poor vision in my right eye after an abrasion? (The clinic doctor mentioned the abrasion is in the center, but I don’t feel pain, only a brief sharp pain when I first open my eyes in the morning.) Will my vision return to normal after the wound heals? Previously, the corneal abrasion caused pain and tearing, but now I don't feel pain.
How can I tell if my wound has healed?
2.
Is it necessary to debride the cornea again to allow the wound to heal properly? If not, will my vision remain blurry? How long does the healing process typically take?
3.
Since my cornea has been injured, the doctor mentioned that the new cornea may not adhere to the eyeball as well as the original one.
Does this mean I will always be at risk of waking up one day with another corneal abrasion? How can I improve this condition? Is surgery the only way to resolve it? I read online that repeated abrasions can leave scars and there is a real risk of blindness.
Is this true? Thank you, Doctor!
Lily, 20~29 year old female. Ask Date: 2022/02/14
Dr. Gao Pilin reply Ophthalmology
Hello Lily:
1.
If the cornea heals properly, it is possible for vision to recover.
However, if there has been an injury, it may have an impact.
If you experience stinging upon waking, it is best to apply artificial tears before opening your eyes to prevent the cornea from sticking together.
If there is no pain, it usually indicates that the damage is not severe; sometimes, minor abrasions may not hurt after a while.
Therefore, it can be difficult to self-assess whether there is a corneal abrasion.
2.
There is no need to completely remove the cornea unless necessary.
As long as it heals without scarring, vision will not be blurred.
Conversely, if scarring occurs, it may lead to blurred vision.
The recovery period varies depending on the individual and the extent of the injury.
3.
Recurrence is possible, so as mentioned, it is essential to apply artificial tears before opening your eyes to improve the situation.
Whether or not permanent scarring occurs may depend on the severity of the injury.
For further information, please refer to: https://bit.ly/3JsHf2s.
I recommend visiting a teaching hospital with a cornea specialty for an examination.
Reply Date: 2022/02/14
More Info
Recurrent corneal erosion (RCE) is a condition that can occur after an initial corneal injury, such as a corneal abrasion. It is characterized by the repeated detachment of the corneal epithelium, leading to episodes of pain, tearing, and blurred vision. Your situation, where you experienced pain upon waking and have noticed a decline in vision, is concerning and warrants a thorough understanding of the condition and potential treatment options.
1. Current Symptoms and Vision Clarity: The fact that you are experiencing significant blurriness in your right eye, even with corrective lenses, suggests that there may still be underlying issues with the cornea. While it is not uncommon for patients with RCE to experience pain or discomfort upon waking, the absence of pain does not necessarily indicate that the cornea has healed completely. The cornea can still be irregular or have areas of epithelial instability, which can lead to visual disturbances. It is essential to follow up with your eye care provider to assess the corneal surface and determine if further treatment is necessary.
2. Corneal Healing and Treatment Options: In some cases, doctors may recommend debridement (removal of the damaged epithelium) to promote healing. However, this is not always necessary, and the decision depends on the severity of the erosion and the condition of the cornea. If your doctor has indicated that the cornea has healed, they may suggest a conservative approach, including the use of lubricating eye drops or ointments to keep the cornea moist and promote healing. The recovery time can vary; some patients may see improvement within weeks, while others may take longer. Regular follow-ups are crucial to monitor the healing process.
3. Long-term Risks and Management: It is true that after an injury, the cornea may not adhere as well as before, leading to a higher risk of recurrent erosions. This does not mean that you will inevitably experience further erosions, but it does mean you should be vigilant about eye care. To manage the symptoms and reduce the risk of future erosions, consider the following:
- Use Artificial Tears: Frequent use of preservative-free artificial tears can help maintain corneal hydration and reduce friction during blinking.
- Nighttime Ointments: Applying a lubricating ointment before bed can help keep the cornea moist overnight, reducing the likelihood of erosions upon waking.
- Avoid Eye Irritants: Protect your eyes from dust, smoke, and other irritants that could exacerbate symptoms.
- Consult a Specialist: If symptoms persist or worsen, consider seeing a corneal specialist who may offer advanced treatments, such as bandage contact lenses, amniotic membrane grafts, or surgical options like phototherapeutic keratectomy (PTK) to smooth the corneal surface.
4. Surgical Options: In cases where conservative management fails, surgical interventions may be considered. PTK can help remove irregularities on the corneal surface, promoting better healing and reducing the risk of future erosions. However, the decision for surgery should be made in consultation with your eye care provider, who can assess the risks and benefits based on your specific situation.
5. Potential for Vision Loss: While recurrent corneal erosions can be bothersome and impact quality of life, they do not necessarily lead to blindness. However, chronic erosions can cause scarring or other complications that may affect vision. Early intervention and proper management are key to preventing long-term issues.
In summary, your symptoms warrant further evaluation and management by an eye care professional. Regular follow-ups, appropriate lubrication, and protective measures can significantly improve your condition and reduce the risk of future episodes. If you have concerns about your vision or the healing process, do not hesitate to seek a second opinion or consult a specialist in corneal diseases.
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