Corneal erosion is a very uncomfortable condition. It is usually a consequence of hit to the eye – by different things. Most often by some stick, finger (usually infant´s finger hit it´s parent´s eye), cardboard (at work) etc.
Symptoms of corneal erosion
If there is an erosion after above mentioned accidents, you will usually immediately feel sharp pain, localized most often under the upper eyelid. Man can hardly open the eye. The eye is tearing. It is so uncomfortable condition (depends on the size of the erosion), that it usually early brings the patient to the doctor.
Treatment of corneal erosion
The doctor examines the patient ideally on the slit lamp. Sometimes instills some dye – usually fluorescein, to see better the extent of the erosion (fluorescein stains the place, where the epithelium – superficial layer of the cornea, is missing).
If the borders of the epithelial defect are not good, sometimes he has to remove them in the local anesthesia. Then he applies into the eye usually an antibiotic or antiseptic oinment (to prevent secondary infection of the wound) and swathes your eye with a bit compressing dressing (because of this compression the eye can´t move under the dressing a lot – it helps the healing and lessers the pain).
Sometimes, when the erosion is big or very very uncomfortable, the doctor can apply bandage contact lens (and you will instill the antiseptic/antibiotic eyedrops thereafter). The contact lens lessers the pain better than compress dressing, but it is not the rule that it is also better for healing the epithelium.
The check in the doctor´s office is usually planned to the next day (in Czech Republic).
How long takes treatment of corneal erosion?
Uncomplicated corneal erosion heals quite quickly. During one or two days the surface of the cornea is usually again covered by epithelium and the pain stops. Corneal surface can be a few more days a bit rough – not optically perfect – so the vision can recover a bit longer time.
If the deepithelized place is contamined with some bacteria (or other infectious agents), the healing process can be significantly longer. And the result – depending on the character of infectious agent – even uncertain.
Recently i had corneal erosion – and now the pain started again
Sometimes, a few weeks after the injury, when everything is already ok, you can feel after awakening in the morning the same pain like after the injury. The erosion can recure. So we call it reccurent corneal erosion.
After the first erosion the epithelium attachement to the underlaying tissue doesn´t have to be very strong. At night, the eyelid sticks to the cornea, and when you open the eye – you tear off the epithelium again.
When this happens only a few times a year, it is not a tragedy. Usually helps to apply some oinment/lubricant before sleeping and immediately after awakening (ideally before opening the eyes..).
If this happens again and again the laser therapy will usually help. Where there is not possible to do the laser therapy – the doctor can try the puncturation of the superficial cornea instead of it.
In the pictures we can see injured superficial layers of the cornea (it´s epithelium). In the right upper picture is the injured place stained by fluorescein (green-yellow color). Along the defect borders in these pictures is not very good epithelium – it will need debridement.
Injury of the corneal epithelium by paper. Notice in the right picture, that the gray defect is only on the convexity of optical section – it means that the injury is superficial.
