Recurrent corneal erosion (RCE) is a painful condition

RCE occurs when the surface of your eye becomes worn and inflamed

Recurrent corneal erosion (RCE) is a painful condition

RCE occurs when the surface of your eye becomes worn and inflamed

RCE can result in significant pain, blurred vision and discomfort

It’s estimated to affect more than 1 million people worldwide and between 5% and 10% of all contact lens wearers

Recurrent Corneal Erosions symptoms

What are Recurrent Corneal Erosions?

The cornea (the clear window of the eye) has epithelial cells. These thin outer layers of cells attach firmly to the underlying layer known as the basement membrane.

When the cornea is damaged, it becomes more delicate than usual. This is due to the epithelial cells, which take at least eight to twelve weeks to regenerate or repair and stick to the epithelial basement membrane.
This is a severe condition as the loss of the epithelial cells exposes the sensitive nerve endings in the cornea.

Recurrent corneal erosion is most common in people who have had an injury to the front of the eye by fingernails, plants or a pet’s claws. Other types of trauma may include chemical burns, foreign bodies and trauma caused by contact lens wear. It may also be caused by corneal diseases such as corneal dystrophy or other corneal diseases, including dry eyes. Diabetic patients may be more prone to this condition.

What are the symptoms?

You may experience recurrent attacks of pain, often towards the end of a nights sleep or upon waking. In addition, you may have difficulty opening your eyelids. Your eye may water and feel sensitive to the light and you may experience a pricking sensation. These symptoms may improve as your day continues and then start again the next day.

Recurrent corneal erosion is the recurrent breakdown of the outermost layer (epithelium) of the cornea.

In recurrent corneal erosions, the cornea’s outer layer fails to glue in tightly to its underlying membrane.

This makes it possible for the epithelium to break off too quickly with little effort.

There are three major causes of recurrent corneal erosion; these include:

  • Previous corneal injury (corneal abrasion)
  • Corneal dystrophy (abnormal structure changes of the cornea)
  • Underlying corneal disease

Diagnosing Recurrent Corneal Erosions

We can diagnose recurrent corneal erosion by taking a careful history to determine any injury to the eye.

We will also measure your visual acuity and instil a special yellow dye called fluorescein. Small areas of the eye will soak up the dye, making erosions visible upon shining a cobalt blue light onto your eye.

Treatment depends on the severity of your condition.

We may prescribe prophylactic antibiotic eye drops to prevent infection in mild conditions in mild conditions. We may also prescribe a dilating drop to relax the iris muscle (coloured part of the eye) to help with the pain.

In more severe cases, we may need to remove the loose epithelium. This process is called debridement.

What happens if the condition recurs?

A recurrent episode will often settle within a few hours or days. We may need to repeat the debridement treatment.

Suppose there is no improvement in the long term, and you have frequent recurrences while using the maximum lubrication. In this instance, we may suggest:

  • Fitting a bandage contact lens (soft lens with no prescription) sometimes for many months to allow the cornea to heal
  • Fitting a soft plastic plug (punctal plug) into the punctum (small drainage hole in the corner of your eye) to keep the eye surface moist most of the time
  • Performing an anterior stromal puncture under local anaesthesia by making discrete tiny punctures away from the cornea centre. This allows the epithelium to adhere better.
  • Having a phototherapeutic keratectomy (PTK) by removing the cornea surface epithelium. This allows new epithelium to grow, more adherent to the underlying basement membrane. This solution is reserved for severe cases.

Corneal diseases are a leading cause of blindness and vision impairment all over the world

Early diagnosis and treatment is key to preventing further damage and restoring vision. Come see us today for an assessment.

Does your corneal eye condition hold you back in life?

If so, we can likely help stabilise or possibly reverse the effect

Talk to us about your corneal eye condition

Whether you’re suffering from an eye infection, corneal abrasion, dry eye, eye allergies or progressive conditions like keratoconus or Fuchs’ dystrophy, we can likely help alleviate symptoms and treat the root cause.

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Academic resources on Recurrent Corneal Erosions

Learn more about Recurrent Corneal Erosions from authoritative sources

The cornea is the clear tissue at the front and center of the eye. Its transparency permits light to pass into the eye, through the pupil, lens, and onto the retina at the back of the eye. The three major corneal layers are the outer layer of the cornea or epithelial layer, the middle layer termed the stroma, and finally, a single layer of cells called the endothelium. Click here for more information.

This paper encompasses corneal disease and is a comprehensive guide to conditions and treatments. Click here for more information.

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Early diagnosis and treatment is key to preventing further damage and restoring vision. Come see us today for an assessment.

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Mr Mohamed Elalfy

MBBCh, MSc, MD, DRCOphth, FRCS (Ed), FRCS (Glas), FRCOphth, FICO, FEBO
Consultant Ophthalmic Surgeon

Seeking eye treatment for a worrying eye condition can be stressful. Waitlists everywhere are long due to the lockdowns, and leaving the house to attend appointments can be a real inconvenience.

To make your experience as easy and stress-free as possible, we provide assessments in your local area. We also offer online appointments both before and after your treatment, so you don’t have to travel far to get the personalised support you deserve.

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