Natural history of recurrent erosion syndrome---a 4 year review of 117 patients

Abstract

Aims/background-Recurrent erosion syndrome encompasses a group of mixed aetiologies for which there are a number of methods of management which may influence the course of the disease. Methods-The outcomes of a cohort of patients initially treated with topical lubricants were studied. 117 consecutive patients presenting over 1 year with a history of recurrent erosions were enrolled, baseline characteristics were documented, and treatment with lubricants was initiated. Patients were surveyed 4 years later inquiring about symptoms and treatments required. Results-A total of 94 (80%) of the initial cohort were contacted. The mean age was 44 years and the sex distribution was 44 males to 50 females. The mean period of follow up was 48 months. 55 (59%) were still symptomatic with attacks occurring at a median frequency of 60 days. 13 patients (24%) complained of an episode at least every week and 28 patients (51%) suVered at least every month. The median pain score (analogue scale of 1-10) was 2.5. Seventy five per cent (n=21) of patients with epithelial basement membrane dystrophy (EBMD) were symptomatic compared with those with a traumatic aetiology among whom 46% (n=28) were symptomatic. This diVerence was significant (p=0.02). Those with EBMD were more likely to be continuing to use topical lubricants than the trauma group. Conclusion-Patients with a traumatic aetiology are less likely to suVer chronic recurrent erosion syndrome than those with EBMD. (Br J Ophthalmol 1998;82:26-28)

Pathogenesis, clinical features and management of recurrent corneal erosions

“…Symptoms of pain, redness, photophobia, and tearing, typically occur on waking and may be related to rapid eye movements during sleep [10][11][12] or rapid opening of the eyelids. Delayed epithelialisation, persistent sloughing of the newly formed epithelium, and recurrent episodes of epithelial loss are common problems.…”

“…Microform erosions may be spontaneous and are associated with epithelial basement membrane dystrophy (EBMD), unlike macroform erosions that are traumatic in origin. 10 ( Figure 1). …”

Combination of transepithelial phototherapeutic keratectomy and autologous serum eyedrops for treatment of recurrent corneal erosions

“…Such recurrent corneal erosions are extremely painful and can affect the lives of the patients (eg, inability to work because most patients with corneal erosions are younger and still in the workforce, repeated consultation with the physician, repeated administration of ointment or drops). 2,3 Several treatment options for corneal erosions are possible depending on the severity: eyedrops or ointment; bandage contact lenses, epithelial abrasion, anterior stromal puncture, phototherapeutic keratectomy (PTK), or transepithelial phototherapeutic keratectomy (t-PTK) using the excimer laser. [1][2][3][4][5][6] The excimer laser treatment is very promising, especially for severe recurrent erosions.…”

“…2,3 Several treatment options for corneal erosions are possible depending on the severity: eyedrops or ointment; bandage contact lenses, epithelial abrasion, anterior stromal puncture, phototherapeutic keratectomy (PTK), or transepithelial phototherapeutic keratectomy (t-PTK) using the excimer laser. [1][2][3][4][5][6] The excimer laser treatment is very promising, especially for severe recurrent erosions. However, following PTK, changes in refraction with a hyperopic shift can occur.…”

Dystrophia Helsinglandica: a new type of hereditary corneal recurrent erosions with late subepithelial fibrosis

“…CDBI have attacks of RCE that fade gradually before coming to an end in young adult life or middle age, but can break out again later in life (Bron & Burgess 1981). Of the non-hereditary causes of RCE, a traumatic origin implies a better prognosis for full recovery than spontaneous forms of RCE (Heyworth et al 1998). …”