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Eye Care (Expert Forum)
Corneal Errosion
Answered by
John C Hagan III, MD, FACS - Ophthalmology
Discover Vision Centers
Kansas City - MO
Our Ask A Doctor Ophthalmology Forum is where you can post your question and receive a personal answer from physicians affiliated with the American Academy of Ophthalmology.
Corneal Errosion
by mgh.hill, Jun 19, 2007 12:00AM
My ophthomologist has already performed Strauma Punctures twice to my right eye for treatment of corneal errosion. At 3 weeks post following the second procedure I am again having errosion episodes. My ophthomologist is telling me that I do not scar well and he is not seeing the scar tissues he would like to see. Does this mean that the strauma punctures aren't going to work for me and if not what if anything else can be done? I have had corneal errosions for approximately 15 years following an injury to my eye but they were in the past only occuring occasionally and was not that bad and was releaved by petroleum ointment. 02/2007 the errosions became much more frequent averaging 2-3 times or more a week and more severe in pain sometimes taking 2-4 hours for the pain to subside to a tolerable measure.
Doctor's Answer
by John C Hagan III, MD, FACS, Jun 19, 2007 12:00AM
, Jun 19, 2007 12:00AM
Recurrent corneal erosions are the bane of the practice of ophthalmology for both the ophthalmologist (Eye MD) and the poor patient. I saw 2 of them in the office today. They can be very difficult and recalcitrant to treat. Not infrequently they are controled with drops and ointments but reoccur if these medications are stopped. I'm sure you're well versed on the medical and preventive treatment of corneal erosions. The next step is what you're having----corneal stromal micro-punctures.
If the problem persists then you may need to discuss these treatments with your ophthalmologist. He/she should be able to do the first method. The second he/she may or may not be able to do, sometimes referral to a cornea specialist is indicated.
1. There is a new method of treatment when all else fails. It involves taking oral tetracycline for a couple of weeks coupled with steroid eye drops. If your ophthalmologist is not familiar with the method he/she can do a literature search of the medical ophthalmology journals. The first time I read of it was in the journal 'Ophthalmology'. I have used this method on two patients that were 'at their wits end and had tried everything else. In both cases it worked. I still have them use an ointment at bedtime such as Muro 128 or Genteal Gel but the severe pain has stopped.
2. The last technique would be to use the eximer laser to 'resurface' the corneal epethelium and soft contact lens wear during the healing. This technique is most often used when the cornea has disease that keeps causing the erosions, the most common of these is corneal epethelial basement membrane disorder.
Keep trying and good luck.
JCH MD
If the problem persists then you may need to discuss these treatments with your ophthalmologist. He/she should be able to do the first method. The second he/she may or may not be able to do, sometimes referral to a cornea specialist is indicated.
1. There is a new method of treatment when all else fails. It involves taking oral tetracycline for a couple of weeks coupled with steroid eye drops. If your ophthalmologist is not familiar with the method he/she can do a literature search of the medical ophthalmology journals. The first time I read of it was in the journal 'Ophthalmology'. I have used this method on two patients that were 'at their wits end and had tried everything else. In both cases it worked. I still have them use an ointment at bedtime such as Muro 128 or Genteal Gel but the severe pain has stopped.
2. The last technique would be to use the eximer laser to 'resurface' the corneal epethelium and soft contact lens wear during the healing. This technique is most often used when the cornea has disease that keeps causing the erosions, the most common of these is corneal epethelial basement membrane disorder.
Keep trying and good luck.
JCH MD
Scott B. Naples, Fl.