corneal abrasion - blurred vision and eye still tender one week later

[Zootal]

I suffered a corneal abrasion one week ago. Got hit in face with small tree branch. Eye very painful, vision clouded. Went to urgent care. Diagnosed corneal abrasion and sent me home. Gave me Neo/poly/dex drops. Put one drop in eye 4 times a day for one week. Today is the seventh day, and the last day I am to use the drops.
Followed up with eye doctor (optometrist) on third day. She put dye in eye and used slit lamp microscope thing. She said abrasions were healing nicely, there is some clouding of cornea. This was mostly cleared up two days later at a second visit (five days after injury) and she said I didn't need to see her unless things got worse.

Today is day eight (it happened a week ago today). My vision is still slightly blurred and lights are slightly streaked (astigmatism?). I can read and use the computer just fine, the blurring is not enough to keep me from doing that, but still noticeable. I look at a point light source, and I can see a slight streaking effect. The eye has no visible symptoms - no redness, no swelling, no puffiness, etc. It is tender and drys out easily, and I tend to keep it closed part of the time.

Is this normal to still have some discomfort and drying after a week? How long do these symptoms normally last? Do vision changes like this eventually go away? And lastly, how long should I wait before going back to my eye doctor if I'm still having discomfort or vision changes don't go away? (Or should I have seen an ophthalmologist instead)?

[JohnHaganMD]

Well best of luck.  Be sure you family knows about your problems as Fuchs is sometimes hereditary

JCH MD

[Mprgan]

Read your previous response.  Yes I should have said my disease was Fuchs.I had a cataract removed and was told that accelerates Fuchs.  What I was confused about is the milky vision I have evn though the antibiotics are doing their job .  I was wearing a bandaid contact lenses but it had to be removed because of the infection. I am told there is significant improvement but the hazy sight i is frustrating....

[Mprgan]

The blister that burst is a result of the Fuchs.  As a Fuchs patient I am in need of the transplant as it is centrally located.

[JohnHaganMD]

Now you tell me.  That is a whole different deal.  Corneal transplants are no longer done for Fuchs Dystrophy that fail.  Generally infection is not a part of Fuchs Dystrophy.   This is a previous  response I made about Fuchs:

There is no exact definition of how many guttatta it takes to diagnosis Fuchs' Endothelial Corneal Dystrophy. Some guttatta are part of aging and do not ever become a problem. Two tests that are often helpful are corneal endothelial cell counts (the number decreases as the disease develops and progresses) and corneal pachymetry (corneal thickness) the thickness increasing as the disease develops and progresses. Family history is useful as many cases of Fuchs' are hereditary (affecting females more than males). Guttata are 'bumps' that develop on the back of the cornea when there are not enough endothelial cells to cover it. These cells are very important as they pump fluid out of the cornea and into the anterior chamber of the eye. The cornea is hydrophilic (water loving) like a sponge. When it swells and gets thicker it starts to become cloudy and blur the vision. When this happens and the impairment is severed than a corneal transplant is indicated. Recently a new operation for decompensated Fuchs' dystrophy called DSEAK (Descemet's membrane epithelial automated keratoplasty) has dramatically speeded the healing, safety and results over full thickness penetrating keratoplasty. Corneal endothelial cells do not multiply or replace themselves when damaged or cell death occurs.

Cataract surgery will not cause Fuchs' dystrophy but cataract surgery (or for that matter any surgery inside the eye) will stress the cornea and in severe Fuchs' could be the final straw that causes the cornea to compensate.

Your doctor is absolutely correct. In my patients with progressive Fuchs's dystrophy I recommend cataract surgery SOONER rather than later because the advanced, "hard" cataract will put much more stress and strain on the cornea endothelium than a moderately firm or softer cataract. Fuchs' dystrophy can decompensate on its own without any surgery taking place or any cataract in the eye.

It would be helpful to know if your mother's problem with her eye's was Fuchs' dystrophy. It is unusual for Fuchs' to cause an eye to be removed, so there's a good chance she had something else.

I would go ahead and have the cataract surgery when you vision starts to be a moderate problem for you and the cataract is the cause. By using the endothelial cell count and corneal thickness, your ophthalmologist can give you a reasonable risk of the cornea being able to stand your cataract surgery.

Good luck, new cataract surgical techniques are much, much more gentle on the eye than techniques used in the past.

JCH MD

[Mprgan]

I have much to learn about my eye disease which is Fuchs dystrophy.  It is in my right eye too but just beginning....muro 128 helps both eyes at the moment.thanks for your comments.....

[JohnHaganMD]

You are not understanding. If the vision clears up you don't need a cornea operation. Most likely what you are calling an infection has scarred your cornea to the point where your doctors don't expect it to clear up.  The purpose of cornea surgery is to restore a clear, unscarred cornea

JCH MD