There are several corneal conditions that can affect your eye health, vision, comfort including recurrent corneal erosion or “scratched cornea”, pterygium and Stevens – Johnson syndrome (SJS).
Recurrent Corneal Erosion
Recurrent Corneal Erosion (RCE) is a condition of the cornea whereby there is a poor attachment of the outermost layer of the cornea, the epithelium, to the underlying basement membrane layer, called Bowman’s Membrane. Patients who experience Recurrent Corneal Erosion may experience sharp pain, light sensitivity, tearing and watering of their eyes, and a gritty sensation. Often this occurs upon awakening or rubbing the eyes. Recurrent Corneal Erosion is a condition that may be associated with Map-Dot-Fingerprint Dystrophy. We may initially prescribe salt solution eye drops or ointment as the first line of treatment. This medication helps the epithelium to adhere more firmly to Bowman’s Membrane. Usually artificial tears are also recommended to keep the cornea moist. Sometimes, a soft bandage contact lens will be used to help the healing process.
Those patients who have a corneal dystrophy may require additional treatment. This usually includes an in-office procedure called “stromal puncture”. Microscopic “spot welds” are made on the cornea with a special needle, under local anesthesia, to encourage the epithelial layer to bond securely to Bowman’s Membrane. For those patients, who continue to suffer from Recurrent Corneal Erosions despite the treatments described, we may recommend Phototherapeutic Keratectomy (PTK) which involves removal of the superficial layer of corneal cells using the Excimer Laser to encourage proper healing.
A pterygium is a fleshy triangular growth of tissue on the cornea that may grow slowly throughout a person’s life.
Rarely, a pterygium can grow across the cornea and block the pupil. People who live in sunny climates where they are exposed to more sunlight and UV light are more prone to developing pterygia. Pterygia may become red, swollen and inflamed and sometimes they need to be removed. Removal of a pterygium is a surgical procedure that has recently undergone medical advances including a technique we now use called Amniotic Membrane Graft in order to prevent recurrences and obtain the best possible results for pterygium surgery.
Stevens-Johnson Syndrome (SJS)
Stevens-Johnson Syndrome, also called Erythema Multiforme, is a disease of the skin that also affects the eyes. SJS causes blistering and painful lesions on the skin and mucous membranes throughout the body. If SJS is extreme it can cause conjunctivitis, corneal blisters and erosions or iritis-an inflammation of the iris. While the exact cause of SJS is not clear, it is believed that it can occur from an adverse reaction to drugs such as sulfa containing drugs. SJS can occur in any age group but seems more common in those under 30 years of age.