What is Recurrent Erosion Syndrome (RES)?
Recurrent Erosion Syndrome (RES) refers to repeated episodes of superficial spontaneous abrasions leading to severe eye pain. Erosions are "scratches" on the surface of the cornea, the clear portion of the eye overlying the iris and the pupil. In many cases, the cells of the outer layer of the cornea are loosely attached to the underlying tissue. These cells spontaneously slough leading to recurrent erosions. Most episodes occur without an identifiable precipitant.
What are the symptoms of Recurrent Erosion Syndrome (RES)?
Patients typically present with attacks of mild to severe eye pain, redness, tearing, and light sensitivity. Some patients may report blurred vision. Most patients report symptoms after awakening fromsleep. During REM sleep, the eyelids contact the moving cornea leading to abrasions, which present with the symptoms listed above.
Are there any risk factors that predispose to the development of RES?
RES typically occurs in eyes that have suffered from a sharp, abrading injury such as from a fingernail or paper cut. The area heals acutely, but is prone to recurrent erosions in the future. Some patients may have an underlying corneal dystrophy that predisposes to RES.
What is the treatment for RES?
Treatment is largely preventative and involves a stepwise approach.
- Aggressive lubrication with artificial tears is recommended combined with artificial tear ointment at bedtime.
- If there is no relief with aggressive lubrication, a therapeutic bandage soft contact lens may be used to prevent further erosions. This specially designed contact lens is left on the eye for several months without removal in an attempt to prevent further corneal abrasions and promote better healing. Antibiotic drops are used to prevent infections secondary to long-term therapeutic contact lens use. Most patients recover completely with aggressive lubrication and/or placement of a bandage contact lens.
- Anterior stromal puncture consists of making tiny holes on the surface of the cornea to promote stronger attachments between corneal cells and the underlying substrate.
- Superficial keratectomy, the latter performed with either a scalpel or a laser Ablation with an excimer laser, the same laser used for refractive surgery, can be used in refractory cases to smoothen the substrate, promoting better healing
- Alcohol Delamination is curative in almost all cases of recurrent erosion syndrome. This procedure is performed by specialist surgeons and involves applying 20% alcohol to the cornea, removing the abnormal surface and allowing new healthy cells to form.
Please contact our specialist team for more information.
If you have been affected by any of the symptoms mentioned above, please don't hesitate to give us a call.
We have a team of experts on stand-by who are ready to take your call at our Manchester (0161 907 2685) Clinic or our Blackpool (01253 308 031) Clinic.