Recurring Corneal Erosion (RCE) and multiple sclerosis (MS)

[moores]

I saw on another thread that there is a link between RCE and autoimmune diseases, such as MS.  Is this true?

I got diagnosed with MS three years ago.  I have been suffering from RCE for a little longer than that.

I have done all of the muro, lubricating stuff, and just recently had the laser surgery to roughen up the surfact.  It didn't work.  If anything, the RCE has come back with a vengence.

My doctor hasn't tried the oral tetracycline for a couple of weeks coupled with steroid eye drops.  I may suggest that on my next visit.

Any help is appreciated.

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

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[sandhya60]

thanks for your comments Dr., and although a lay person, the way I understand it is if it becomes severe, the outer most layer of the eye in repeated episodes or if it gets "real bad" can result in major issues because of repeated injury to the cornea.  
I didnt even know I had it, only because either my Opth. never brought it up or because I thought pain was a normal part of aging, it really is not.

I do know a little bit about eye disorders, and thought my "eyelid sticking to my eyes in the morning and having to rip the lids off" was normal.

I had cataracts surgery at an early age, which was from familial genetic traits, (8 members of the family over 2 generations) and I too was curious about auto immune disorders associated with this.

Although I do know that it may be unrelated, I know there is allot of things Drs. do not know about associated disorders, also about genetics. I will be following this topic. Thanks everyone for the input.

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

I do not believe there is any relationship of Multiple Sclerosis and recurrent erosion. I think you've seen this but there was another question today so I wanted to post it again.
JCH MD

You have "recurrent corneal erosion syndrome". The condition is common and will not destroy your sight or cause serious loss of vision. It has been discussed in the past in the eye care forums. It usually starts after a scratched cornea that does not heal properly. In some instances it occurs due to a common disease of the outer layer of the cornea (basement membrane disorder). Use the search feature and type in "corneal erosions".

Here is part of a recent post on the problem:

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 controlled 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.

Treatment is to avoid anything that dries the eye. So keep it moist with artificial tears. At bedtime a lubricating drop with normal saline (Muro 128 ointment---available over the counter) is put in the eye.  Extreme care must be used in the morning on awakening as this is when the tissue usually tears. Avoid rubbing the eye. If the eye wants to stay shut from the ointment leave it shut, splash with warm water till it opens then put in an artificial tear or Muro 128 DROPS (available as 2% or 5% [which often stings] also available over the counter. If Muro 128 products are irritation try Refresh-PM ointment at bedtime and a good artificial tear on awakening and several times during the day (Systane, Opteve, Soothe, Refresh, Tears Naturale, etc).

Long plane and car trips are very stressing for corneal erosions. In the car, run the air conditioner or heater on the feet vents not into the face. Put artificial tears in the eye every couple of hours on a car trip and every hour on a plane trip.

You should go a minimum of 4 months without any pain from the erosion (usually during sleep or upon wakening) before trying to stop the ointment. Be aware that some people are never able to stop the medications and must use drops, ointments and precautions indefinitely (years and years).

The next step is often corneal stromal micro-punctures. This is an office procedure done with just eye drop anesthesia; a bandage contact lens is put in the eye for several days. You may return to normal physical activities immediately.  

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 epithelium 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 epithelial basement membrane disorder.

Keep trying and good luck.