Discomfort after Corneal Abrasion

[rusyixun]

Dear all,

Eight weeks ago on a trip to the US I contrived to launch a bottle of shower gel into my right eye. The next day I experienced photophobia, sharp pains, and discomfort when moving the eye around and reading things up close. A US ophthalmologist diagnosed a corneal abrasion at the six o'clock of my eye (below the iris) and prescribed antibiotic ointment for 3 days, sure I would be 100% by then. Indeed the photophobia and sharp pain cleared up quickly but the discomfort did not.

The sharp pain returned to a lesser extent three weeks after the accident so I saw a local (Singaporean) ophthalmologist. With her microscope she discovered that the initial abrasion had healed but was not securely attached from dryness, and prescribed Optive drops and Vidiscic gel, which I continue to use today. Two days later my cornea looked okay under the microscope and within a week the sharp pain had gone. Unfortunately the discomfort has never gone away, and seems to have stayed at the same level since the accident. (five weeks from the beginning of lubrication treatment)

My vision remains 20/20 in both eyes, but I feel I no longer see objects up close (when reading etc.) as well or effortlessly as I used to. There is a sense of discomfort, almost like a sliding of something in the eye, when moving the right eye around and "focusing" on distant objects. Moving the eye too fast will actually cause a twinge of pain. My ophthalmologist doesn't see anything wrong with the eye and suggested that I was experiencing dry eye due to the cornea no longer being as smooth as before.

I have read up on abrasions, erosions and dry eye. Presumably I came close to experiencing an erosion just before I started the lubrication regimen. I haven't been able to find much information on dry eye after corneal abrasions.  Obviously my condition is bearable but I do hope that is temporary, perhaps with some deep layer of the cornea still healing. Would appreciate any enlightenment.

[JohnHaganMD]

Most do.  I tell people not to stop ointment or gel at bedtime until they've gone 4 months without symptoms. Then they can try and stop. It it reoccurs suggest use gel at bedtime indefinitely

[rusyixun]

Thanks again. I forgot to ask: from your link this is a permanent problem for some people, but in your experience do most people make a full recovery with lubrication, and on what kind of time scale?

[JohnHaganMD]

I can't answer your last question.  Muro 128 does not make dry eyes worse. It is over the counter and you should be able to order on internet. I do not know anything about Vidsic gel.    I would not comment one way or the other on swimming since I haven't looked at your cornea.  Muro 128 also comes as a 2% drop and 5% drop. The latter often stings and most people prefer the 2%

[rusyixun]

Hi John,

Thanks for your reply. I've read that post previously, it was very helpful. I hadn't read about RCE causing focusing or eye moving problems, but I guess damage to the cornea can cause all kinds of vision problems.

I don't think Muro 128 is available in Singapore, but I could pick some up next time I'm in the States. As I understand the sodium chloride draws water out of the cornea. I wonder if that might make the dryness worse though.

There are many lubricant eye drops available here, but the closest thing to ointment is Vidisic gel. I've read that the cetrimide in Vidisic might cause corneal epithelium damage used over the long term - wonder if you know anything about this?

Final question: my ophthalmologist has cleared me for swimming in a week (I do use googles). Will that be okay?