Managing Recurrent Corneal Erosion: Effective Treatments and Concerns

Q: Managing Recurrent Corneal Erosion: Effective Treatments and Concerns

Hello： 1. <br>For patients with dry eye syndrome, autologous serum eye drops are a common treatment method. <br>Autologous serum eye drops are highly individualized, as they are derived from the patient's own blood, thus minimizing the risk of rejection and effectively alleviatin

Corneal abrasion

Hello, doctor.
For the past two years, I have been suffering from recurrent corneal abrasions due to dry eye.
Initially, I was treated with eye drops, and I have now undergone two punctal occlusions.
I also rely on single-dose artificial tears throughout the day (using about four vials daily) and apply ointment before bed.
However, I still experience corneal abrasions and inflammation approximately every 7 to 10 days.
I would like to ask: 1.
Would autologous serum eye drops be a suitable treatment option moving forward? And 2.
Could low-dose steroid eye drops (0.1%) potentially strengthen the corneal epithelium to prevent abrasions? I use them about once a week when my eyes are red and painful, applying them twice daily, which helps make my eyes feel more comfortable in the following days.
However, I am concerned about potential side effects related to intraocular pressure or glaucoma.
Thank you, doctor.

Cherry, 30~39 year old female. Ask Date: 2023/03/08

Dr. Gao Pilin reply Ophthalmology

Hello: 1.
For patients with dry eye syndrome, autologous serum eye drops are a common treatment method.
Autologous serum eye drops are highly individualized, as they are derived from the patient's own blood, thus minimizing the risk of rejection and effectively alleviating dry eye symptoms.
If your dry eye condition is severe and current treatments are not effective, autologous serum eye drops may be a viable option to consider.
However, you should first consult your ophthalmologist and follow their recommendations for treatment.
2.
Steroid eye drops are typically used to treat inflammation in the eyes, helping to reduce redness, swelling, and pain, as well as decreasing the risk of corneal erosion.
However, long-term use of steroid eye drops may lead to side effects such as increased intraocular pressure and glaucoma, so they must be used cautiously.
If you need to use low-dose steroid eye drops long-term to manage eye inflammation, it is advisable to work closely with your ophthalmologist, regularly monitoring your intraocular pressure and undergoing other necessary examinations to ensure your eye health.
Additionally, you can further optimize your daily habits, such as appropriately adjusting screen time and rest periods, reducing time spent in front of electronic screens, maintaining humidity in indoor air, and following other recommendations provided by your physician to help improve your dry eye symptoms.

Reply Date: 2023/03/08

More Info

Managing recurrent corneal erosion (RCE) can be quite challenging, especially when conventional treatments like artificial tears and punctal plugs do not provide sufficient relief. Your experience with recurrent erosions, despite various interventions, indicates that a more tailored approach may be necessary. Let's address your questions regarding the use of autologous serum eye drops and low-dose steroid eye drops.

1. Autologous Serum Eye Drops: Autologous serum eye drops are derived from your own blood and contain growth factors, vitamins, and other components that can promote healing and provide lubrication. They have been shown to be effective in treating various ocular surface disorders, including dry eye syndrome and recurrent corneal erosions. The use of autologous serum can help in enhancing epithelial healing and reducing inflammation. Given your history of recurrent erosions and the ineffectiveness of other treatments, autologous serum eye drops could indeed be a suitable next step. However, it is essential to have a thorough discussion with your ophthalmologist about the preparation, application, and potential benefits of this treatment.

2. Low-Dose Steroid Eye Drops (0.1%): The use of low-dose steroids in managing corneal erosions can be somewhat controversial. While steroids can reduce inflammation and may help in stabilizing the corneal epithelium, they also carry risks, particularly concerning intraocular pressure (IOP) and the potential development of glaucoma. Using a low-dose steroid eye drop occasionally, as you described, may provide temporary relief during flare-ups. However, it is crucial to monitor your eye pressure regularly, especially if you are using steroids frequently. Your ophthalmologist can help determine the appropriate balance between managing inflammation and minimizing the risk of elevated IOP.

In addition to these treatments, consider the following strategies that may help manage your condition:
- Bandage Contact Lenses: These lenses can provide a protective barrier over the cornea, allowing it to heal while reducing discomfort and the risk of further erosions.

- Surgical Options: If conservative measures fail, surgical interventions such as anterior stromal puncture or laser treatments may be considered to promote adhesion of the epithelium to the underlying stroma.

- Lifestyle Modifications: Ensure that you are managing any underlying conditions that may contribute to dry eyes, such as systemic diseases or environmental factors. Staying hydrated and using a humidifier can also help.

- Regular Follow-Up: Continuous monitoring by your ophthalmologist is vital to assess the effectiveness of any new treatment and to make adjustments as necessary.

In conclusion, autologous serum eye drops may be a beneficial addition to your treatment regimen for recurrent corneal erosion, while low-dose steroid eye drops can provide temporary relief but require careful monitoring for potential side effects. It is essential to work closely with your ophthalmologist to develop a comprehensive management plan tailored to your specific needs and to explore all available options to improve your quality of life.

Similar Q&A

Managing Recurrent Corneal Erosion: Challenges and Treatment Options

Hello, Doctor! My wife experienced her first corneal abrasion in February of last year. She received treatment from a cornea specialist, who prescribed artificial tears and a tear film ointment, but she still frequently experiences her eyelids sticking together, causing pulling a...

Dr. Gao Pilin reply Ophthalmology
Hello: First, your wife's medication regimen already includes artificial tears and a tear film ointment, which are standard treatments for dry eye syndrome. However, if her eyelids are still sticking together during sleep and exacerbating her symptoms, it may be necessary to...

Managing Recurrent Corneal Erosion After Eye Injury: A Patient's Journey

Hello doctor, I accidentally fell in July and my nail scratched my cornea, resulting in a 3mm x 3mm wound that did not cover the pupil. At that time, the recovery was quite good and it healed in about a week without any discomfort. However, on November 8th, when I woke up, it see...

Dr. Gao Pilin reply Ophthalmology
Hello Alice: The simplest method is to apply the ointment every night before bed, and before opening your eyes in the morning, use artificial tears first, then slowly open your eyes to avoid sticking the newly formed epithelium. During the day, use preservative-free artificial te...

Understanding Recurrent Corneal Erosion: Causes and Management Strategies

Hello Doctor: I underwent a corneal epithelial debridement surgery (without laser) on my right eye on March 22 and wore therapeutic contact lenses for two weeks. After removing the lenses, I consistently used artificial tears and tear film ointment daily, but I still experience r...

Dr. Cai Wenyuan reply Ophthalmology
Hello: If it is indeed recurrent corneal erosion, it can be difficult to manage and prone to recurrence. It may be best to continue seeking medical treatment. Wishing you safety and health. Sincerely, Dr. Cai Wenyuan, Director of Ophthalmology, Taoyuan Hospital, Ministry of Healt...

Persistent Corneal Erosion: Seeking Solutions for Ongoing Eye Pain

Hello, Doctor. When I was five months pregnant, I suddenly experienced eye pain. After an examination, I was diagnosed with a corneal abrasion. On average, I would experience pain once a month. Due to my pregnancy, I did not undergo any other treatments at that time, only using e...

Dr. Gao Pilin reply Ophthalmology
Hello: Based on your description of the condition, it appears to be recurrent corneal erosion. This occurs when the epithelium of the cornea is damaged (corneal abrasion), and the regeneration of the epithelium does not adhere tightly enough to the basement membrane and Bowman&#x...