what is the cause of my eye irritation at night?

[Charles130]

for some time now i have been having constant irritation in my left eye. it brings out tears profusely and i feel like there's so much sand in m eye. i can't open my eyes when there's light, usually it happens only at night and about twice a month but it's happening very often these days like twice a week. last night it happened and till now i still feel the sharp pain and the bad irritation on my left eye. this is really beginning to scare me and worse is that i have no money to see a doctor at the moment. please i need help. i need to know exactly what's wrong with my eye.

[JohnHaganMD]

This is a previous post on the problem I pulled up:
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.

[JohnHaganMD]

I'm going to assume you don't wear contact lens or have sleep apnea and sear a CPAP if you do that is the most common cause. If you don't the problem is likely "exposure keratitis and recurrent corneal erosions" Use the search feature and read the previous posts its a common problem. You can also do internet search and read more on each term.  Don't sleep under a fan and before you go to sleep EVERY night put in an over the counter lubricating gel (not regular artificial tears which won't last all night)  good and common brands are: Genteal Gel, Systane PM, Refresh Liquigel  look for word "gel" on bottle.  Use at bedtime for 3 months. If no pain and you want to see if you can get buy without them you can try. Some people have to do this every night. No problem with long term use of gels like putting moisturizer on skin