CORNEAL EROSION

CORNEAL EROSION

Since the corneal epithelium and its basement membrane are of different embryological origin, the connection between them is weak. Therefore even a small trauma can cause erosion, i.e. the separation of epithelium from the surface. Therefore, the erosion of the cornea is most frequent eye trauma. Stripped nerve fibers at the site of erosion are very sensitive, so the even contact with the eyelid causes a feeling of foreign body and pain.

CORNEAL EROSION

 

Symptoms:


Trias of signs of stimuli to the anterior eye segment appear: photophobia, epiphora and blepharospasm. Sometimes ciliary hyperemia also occurs.


With each erosion, the eyelid should be uplifted in order to find the residual foreign body (usually – on the coupling of the upper tarsus).

Treatment:


Antibiotic drops or ointment three times a day;
analgesics as needed; eye patch is used if it makes the patient more comfortable. Antibiotics reduce risk of infection. In addition, grease reduces friction between the bare nerve endings and eyelids. With smaller erosions, occlusion of the eye is not required.


Corneal epithelium is renewed from the periphery toward the center and from deeper layers towards the surface. If the damage is on the epithelium of the entire cornea, it will be restored only if at least part of the limbal epithelium is preserved which has a great ability to recovery. If there is no infection or injury in deeper layers of the cornea, exudation takes place very quickly: one millimeter of the edge of erosion daily produces one square millimeter of epithelium, respectively – the diameter of the erosion is reducing on a daily basis for almost two millimeters. Therefore, most erosions heal in a day or two.


Secondary infections and damage in the deeper layers can cause permanent corneal opacification.

Recurrent corneal erosion


It is caused by inherently weak connection of the epithelium with the basal membrane. Every few weeks or months, the corneal erosion of the epithelium spontaneously arises, typically in the morning at the opening of the eyes during waking.


Treatment:

 

Prolonged wearing of the therapeutic contact lenses for several weeks to several months, with the use of lubricants. If erosion is not in the optical zone, it is possible to gently poke cornea with the insulin needle. The procedure is called stromal puncture. The aim of both procedures is to ensure that the epithelium better adheres to the basal membrane.