Corneal Ulcer Scarring and Vision Recovery Strategies

Q: Corneal Ulcer Scarring and Vision Recovery Strategies

Hello： 1. <br>The treatment duration for rigid gas permeable contact lenses varies depending on the situation, generally ranging from several months to a year. <br>It is important to maintain cleanliness and care while using contact lenses, follow the physician's instructions for

Corneal ulcer scar

Hello, doctor.
Recently, I returned to a large hospital for a follow-up regarding a corneal ulcer infection.
I was treated with Levofloxacin, Cefazolin Sodium injection, and Betamethasone Disodium Phosphate eye drops.
The doctor mentioned that the ulcer and infection have mostly healed, but there is a scar located near the center of my eye, which is affecting my vision.
Currently, my vision has improved to 0.5.
The doctor suggested treatment with rigid gas permeable contact lenses.
I have a few questions:
1.
How long does the treatment with rigid gas permeable contact lenses take, and what should I be aware of?
2.
Why is it not suitable to start this treatment immediately after the ulcer has healed? The doctor recommended continuing to observe and returning for follow-up in a month or a few months.
3.
The doctor said I can continue using the antibiotics and steroid eye drops as prescribed: antibiotics four times a day and steroids twice a day.
Since the doctor indicated that I am mostly healed, why is it necessary to continue these medications? Do they help with the recovery of my eye? Is there a risk of overusing antibiotics and steroids? I still have 5 ml of antibiotics and 7 vials of steroids (0.5 ml each).
4.
For future follow-ups and vision improvement, can I go to a general clinic, or would it be better to visit a large hospital?
5.
Although my vision has improved, I still find it somewhat strenuous to see clearly.
I have difficulty seeing at a distance, and when looking at traffic lights or car headlights, I experience light halos and ghosting.
When using only the injured eye, I can see nearby objects, but they are not clear.
Could this affect the vision in my uninjured eye?
6.
Are there any other methods to improve my vision? I need to work on a computer and with paper for extended periods, and if I look for too long, my injured eye becomes uncomfortable.
Additionally, I occasionally experience a feeling of pressure or pain in the past two weeks, but it does not last long.
My eye pressure measurements are 19-21.
The uninjured eye measured 26-27 with a larger machine, but only 17 with a smaller one.
Why is there such a significant difference?
Thank you, doctor, for taking the time to respond!

Nìngmíng, 20~29 year old female. Ask Date: 2023/04/06

Dr. Gao Pilin reply Ophthalmology

Hello: 1.
The treatment duration for rigid gas permeable contact lenses varies depending on the situation, generally ranging from several months to a year.
It is important to maintain cleanliness and care while using contact lenses, follow the physician's instructions for usage and replacement, and avoid prolonged wear.
2.
It is not recommended to use rigid gas permeable contact lenses immediately after an ulcer has healed because the eyes need time to recover.
Using contact lenses may cause further damage and infection.
The physician's recommendation to continue observation is to ensure that the eyes have healed sufficiently to tolerate this type of treatment.
3.
The physician recommends continuing the use of antibiotics and steroid eye drops to prevent infection and control inflammation, as these medications remain important during the treatment process.
However, if you have any questions, it is advisable to consult your physician further.
4.
Follow-up care can be done at a general clinic, but if you require specialized treatment or surgery, you may need to return to a major hospital for care.
5.
After an eye injury, vision recovery may take some time, and it may not fully return to the state it was in before the injury.
It is recommended to continue following the physician's instructions for treatment and follow-up to ensure the recovery of the eyes.
6.
Methods to improve vision include the proper use of glasses or contact lenses, adequate rest for the eyes, maintaining proper nutrition and a healthy lifestyle, and avoiding smoke and harmful environmental factors.
7.
Intraocular pressure measurements may vary depending on the measuring instrument used; however, if the differences are significant, it is advisable to recheck to ensure the accuracy of the results.

Reply Date: 2023/04/06

More Info

Corneal ulcers can lead to significant complications, including scarring and vision impairment. Your situation, involving a corneal ulcer that has healed but left a scar affecting your vision, is not uncommon. Let's address your questions and provide some insights into your condition and treatment options.

1. Duration and Considerations for Rigid Gas Permeable (RGP) Contact Lenses: The use of RGP lenses for treating corneal scarring can vary in duration, typically ranging from several months to a year, depending on the severity of the scarring and the individual’s healing response. These lenses can help improve vision by providing a smooth refractive surface over the irregular cornea. However, it is crucial to maintain proper hygiene and follow your doctor's instructions regarding usage and care. Overwearing lenses can lead to complications, including further irritation or infection.

2. Timing for RGP Lens Use: It is generally advised to wait before using RGP lenses after a corneal ulcer has healed. This is because the cornea needs time to stabilize and regain its integrity. Immediately using lenses can risk re-injury or infection, as the cornea may still be sensitive and not fully healed. Your doctor’s recommendation to observe for a few months is to ensure that the cornea has adequately healed and is ready for the additional stress that contact lenses can impose.

3. Continuation of Antibiotics and Steroids: Continuing the use of antibiotics and steroids is often necessary to prevent any potential infections and to manage inflammation. Even if the ulcer appears healed, the underlying tissues may still be vulnerable. The antibiotics help prevent secondary infections, while steroids can reduce inflammation and promote healing. However, it is essential to follow your doctor's guidance on the duration and frequency of these medications, as overuse can lead to complications such as increased intraocular pressure or delayed healing.

4. Follow-up Care: While follow-up care can be done at a general clinic, it is advisable to continue seeing an ophthalmologist, especially one with experience in corneal conditions. They can provide specialized care and monitor for any complications that may arise, ensuring that your recovery is on track.

5. Visual Disturbances: The symptoms you describe, such as difficulty seeing at a distance, halos around lights, and double vision, can be attributed to corneal scarring and irregularities. These issues may not necessarily worsen the vision in your uninjured eye, but they can lead to visual discomfort and strain. It is essential to report these symptoms to your doctor, as they may indicate that further intervention is needed.

6. Improving Vision: To improve your vision and comfort, consider the following strategies:
- Regular Eye Breaks: When working on a computer or reading, take frequent breaks to reduce eye strain. The 20-20-20 rule is helpful: every 20 minutes, look at something 20 feet away for at least 20 seconds.

- Artificial Tears: Using preservative-free artificial tears can help keep your eyes moist and reduce discomfort.

- Proper Lighting: Ensure that your workspace is well-lit to minimize strain on your eyes.

- Consultation for Vision Correction: If your vision does not improve, discuss with your ophthalmologist the possibility of corrective lenses or other interventions.

Regarding the discrepancies in intraocular pressure measurements, variations can occur due to different instruments used or the technique of measurement. It is essential to have consistent monitoring, especially if you have a history of elevated eye pressure.

In summary, your recovery from a corneal ulcer and associated scarring requires careful management and follow-up. Adhering to your doctor's recommendations, maintaining eye health, and addressing any new symptoms promptly will be crucial in your journey toward improved vision.

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