Dry Eye Clinic
Comprehensive diagnosis and treatment of dry eye syndrome, blepharitis, and meibomian gland dysfunction—essential for ocular comfort and optimal surgical outcomes.
Recurrent Corneal Erosions
A painful condition where the corneal epithelium repeatedly breaks down, often upon waking, causing sudden severe pain, watering, and light sensitivity.
Understanding Recurrent Corneal Erosions
Recurrent corneal erosion syndrome (RCES) is a condition where the outermost layer of the cornea—the epithelium—repeatedly breaks down and peels away. This typically happens during sleep or upon waking, causing sudden, intense pain that can be debilitating.
The condition occurs because the epithelium fails to adhere properly to the underlying basement membrane. During sleep, the eyelid can stick to this poorly attached epithelium, and when the eye opens, the surface layer tears away. The resulting corneal abrasion exposes sensitive nerve endings, causing severe pain.
RCES often develops after a previous corneal injury, such as a fingernail scratch or paper cut to the eye. It can also occur spontaneously in patients with epithelial basement membrane dystrophy (EBMD), a common but often undiagnosed corneal condition.
Treatment begins conservatively with intensive lubrication, particularly at night. If conservative measures fail, procedures such as PTK (phototherapeutic keratectomy) or stromal micropuncture can provide lasting relief by promoting proper epithelial adhesion.
Signs You May Notice
If you're experiencing any of these signs, a consultation can help determine the cause and appropriate treatment.
- Sudden severe eye pain, typically upon waking
Often described as sharp, stabbing pain that comes on immediately when opening the eyes
- Watering and tearing
Profuse tears as the eye responds to the corneal damage
- Light sensitivity (photophobia)
Bright light intensifies the pain
- Foreign body sensation
Feeling of something in the eye
- Blurred vision during episodes
Vision clears as the epithelium heals over days
- Recurrent episodes over months or years
The hallmark of the condition is repeated occurrences
Causes
- Previous corneal abrasion or injury (especially fingernail scratches)
- Epithelial basement membrane dystrophy (EBMD/map-dot-fingerprint dystrophy)
- Other anterior corneal dystrophies
- Spontaneous occurrence with no identifiable cause
Risk Factors
- History of corneal injury, particularly from fingernails or paper
- Family history of corneal dystrophy
- Contact lens wear
- Dry eye syndrome
When to Seek Help
Consider booking a consultation if you notice any of the following:
- You experience recurring episodes of severe morning eye pain
- Pain from a previous corneal injury keeps returning
- Episodes are affecting your sleep or daily activities
- Conservative treatment with lubricants is not preventing recurrences
Frequently Asked Questions
During sleep, reduced tear production allows the eyelid to stick to the poorly attached corneal epithelium. When you open your eyes, the eyelid pulls the epithelium away, causing an abrasion. This is why episodes typically occur upon waking.
Treatment starts with intensive lubrication, especially at night—including ointments and hypertonic saline drops. If conservative treatment fails, procedures like PTK (phototherapeutic keratectomy), anterior stromal puncture, or epithelial debridement can provide lasting relief.
Yes, PTK has an 80-90% success rate for providing long-term relief from recurrent erosions. By creating a smooth surface for the epithelium to adhere to, it addresses the underlying problem rather than just treating symptoms.
How We Can Help
Ms. Menassa offers the following treatments for Recurrent Corneal Erosions:
Concerned About Your Eyes?
Ms. Menassa provides thorough, unhurried consultations to assess your condition and discuss the best treatment options for your situation.
Specialist Expertise
As a fellowship-trained Cornea and Anterior Segment specialist, Ms. Menassa has particular expertise in conditions affecting the front of the eye. Her training in Heidelberg and Lucerne ensures you receive care informed by the latest international advances.
Available Treatments
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PTK (Phototherapeutic Keratectomy)
Excimer laser treatment to remove superficial corneal irregularities, scars, and dystrophies, or to treat recurrent corneal erosion syndrome.
Take the First Step
Understanding your condition is the first step toward clear vision. Ms. Menassa is here to provide expert guidance, honest advice, and compassionate care.