Will my super reduced vision/clarity return to normal after large corneal abrasion?

[Brian_J88]

I had a freak accident at work that lead to a superficial but very large (opthalmologist said roughly 70% of front of my eye) corneal abrasion on my left dominant eye. I also want to mention I had Lasik about a year and a half ago and the flap was  completely unaffected. It's been 2 and a half weeks since the abrasion and everything on the surface has healed nicely (opthalmologist confirmed herself) and I haven't had any recurring corneal abrasions since, but my vision in my left eye is still terrible (double vision, can't read street signs or license plates unless I am literally right next to them).I haven't noticed  any improvement over these 2 weeks. My opthalmologist wants to give it time before trying glasses or contacts, but my head is swimming every day since it happened due to the two different visions in each eye. Any advice or similar stories would be helpful,thanks for reading!

[John C Hagan III, MD, FACS, FAAO]

Hopefully you are seeing the same ophthalmologist that did your LASIK. If not go in to see the LASIK surgeon.   Hopefully you are using artificial tears and ask your surgeon about using Muro 128 eye drops or ointment at bedtime.  You are at high risk of recurrent corneal erosion. It could easily take a couple of months for your cornea to heal.

[Brian_J88]

Yes I did go to the same opthalmologist that did my Lasik procedure, and luckily she checked and rechecked the flap to make sure it was unaffected. I want to ask a million more questions but I'll just narrow it down to 2 lol. Will Muro 128 help in the actual healing process of the cornea or is it just used to prevent recurrent corneal erosion? And if I was your patient, at what point time length wise, would you make the call that my vision might not get better, and potentially recommend glasses or contacts? Thanks again  for your prompt response, I see you have answered many questions on here and I think I speak for everyone when I say thanks for all you do!

[John C Hagan III, MD, FACS, FAAO]

Muro is used to help the cornea heal as well as prevent RCEs.   If the problem is uneven cornea (irregular astigmatism) glasses and contacts aren't going to help much.

[Brian_J88]

Update for those who may have read this with similar problems. It's been almost 2 months and that RCE thing is no joke. My eye got better back to 20/20 during the daytime after a prolonged time with no RCE, but still stayed very blurry with double vision during the night (I'm a frequent night driver for work so I had the pleasure of studying it daily) which according to my opthamologist is very unusual ::eye roll::. The I started getting the erosions constantly about 2 weeks ago which has halted progress immensely. I'm using nighttime gel now daily and I tried a bandage contact lens but it still erodes quite frequently, thus making the eye swell for a couple of days and then further pushing progress of my clear vision back. Its a very frustrating process

One thing to note as well: my eye measured a -.25 after Lasik a year ago and a couple of weeks ago measured .-25 once again during the prolonged period with no RCE. Upon request of a contact bandage lens a week ago, the Dr. only had a .-75 lens in the office to give me, she stated it would make my vision blurry. Once i put it in it actually sharpened up my vision immensely, so I guess Im really confused about that especially because it fixed all my night vision problems as well. Could I have developed a stronger prescription from this abrasion?

[John C Hagan III, MD, FACS, FAAO]

Your "story" is common with recurrent corneal erosions (RCE).    You could have some temporary swelling of the cornea that make the eye more myopic but its likely at night when your pupil dilates your post lasik refractive error is closer to -0.75. This is called "night myopia"  wearing glasses with a RX like -0.75 at night should solve the night vision problem.   The ointment this is generally used for severe RCE at night is Muro 128 Ophthalmic Ointment. It works much better than gel. Ask your eye MD about it. If the problems continue other more aggressive treatment are corneal micropunctures or surface scraping of the cornea and bandage contact lens. If you have traditional 'flap'lasik your surgeon may not want this done.

[Brian_J88]

Long overdue update: vision for the most part has returned to almost pre incident status, however, it seems that eye has a harder time focusing. I still take great precaution in preventing RCE every night(Muro, goggles, no moving air) and it's starting to become a nuisance, as I miss sleeping with a fan on. The occurrences have been far and few between though, only  happens once every other month or so. According to my opthalmologist the Bowman's membrane has one small spot that may have a "fold" that is continuing to cause RCE in one tiny spot, and the still remaining decrease in clarity. I am starting to think a corneal scrape may help, but am unsure if the procedure can be done since I had Lasik 2 years prior to the injury. I suggested it to my opthalmologist last visit (approx 2 months ago) and she said she wants to give it more time before considering the scraping option. I guess I'm curious as to how long one should wait before getting on the offense, it's been almost 9 months and I am really hoping I don't have to deal with this the rest of my life.

[JohnHaganMD]

I do have patients that deal with this the rest of their lives (ointment at bedtime,  artificial tears during day, avoid drying, etc.)  Scraping the cornea is a big deal especially in a LASIK patient and does not guarantee you won't have problem and even if it did clear that tiny spot you would need to use same precautions, drops, gels, ointments that you are using now. If it doesn't clear up ask your surgeon about doing "cornea micropunctures for RCE' rather than scraping the entire cornea. We have had much success in our office with this and much faster healing and less expensive.