How to improve from recurrent corneal erosion?!
Question:
How to improve from recurrent corneal erosion?
Recurrent corneal erosion is a disorder of the eyes characterized by the failure of the cornea's outermost layer of epithelial cells to attach to the underlying basement membrane.
My symptom is very minor but my eye hurts sometimes when I try to open my eye the first thing when I wake up. Will the condition gets better over time or do I have to live with this.
Answers:
The cornea has a number of layers. The outermost is the epithelium which sits on its basement membrane. Under this is the stroma which is made of collagen fibers running parallel to each other, going different directions, in multiple layers, then the innermost layer, Decemet's membrane, then the single cell layer the endothelium.
The epithelium is like the skin. It's base layers are sort of square, then they flatten out as they go towards the surface in mutltiple layers.
The epithelium is scrapped off when you blink, little by little, and those cells are replaced by the cells underneath.
When you sleep at night, and get all cozy, into deep sleep, your eye doesn't close completely. It leaves a small space or crack open to the air. This area gets dry. As it gets dry, it can stick to the lid margin. Then, when you go into REM (rapid eye movement) sleep, and you sort of start chasing rabbits in your sleep, you move your eyes and the surface layers tear. OUCH. The eye feels like someone scraped it, or that there's something in there. If you go back to sleep, it'll regenerate the defect and by morning most of the foreign body feeling will be gone.
When this happens more and more, the cells on the bottom will close the defect, but there isn't a basement membrane beneath them as that takes longer to regenerate, so they won't stick tightly. It then becomes easier for the erosion or tearing to happen, thus recurrent erosion.
If you have a mild blepharitis, or lid inflammation, which is usually associated with Staph. bacteria, the secretions of the lid, the fibrin, the cellular reaction and the salts in the tears themselves make the lids a bit more sticky. The lid margine will stick to the drying cornea which is exposed.
To avoid the erosion and allow the basement membrane to replace itself over a month or so, you'll have to put some type of oily, oil-like lubricant between the eye and the lid when you sleep. You could try refresh PM or other ointment such as Bacitracin, Erythromycin ophthalmic ointment or others. I've had this problem in the past and have used just plain old vaseline. It causes the vision to get a bit yellow, but you can wash it out in the morning with water and it won't do any harm to the ocular surface. The ophthalmic ointments require a prescription which shouldn't be that hard to get from your eye doc. They are 'sterile' too. But your eye isn't, so in a pinch the vaseline does work.
Once you've allowed the basement membrane to be replaced, you won't need the ointment. But, if you continue to sleep with your eyes partially open, which you don't really have all that much control over, it'll happen again...hence RECURRENT.