An initial scratch on your cornea damages its outermost layer and does not completely heal, forming a blister. The blister’s surface can stick to the underside of your eyelid, usually while you are sleeping, or after you have been in dry, dusty environments.
When you open your eye, the blister may pop or tear and the damage reappears. This will usually make your eye painful and watery during the night or first thing in the morning, and you may also experience blurring of your vision and sensitivity to light. This may happen many months or years after the initial injury and may occur repeatedly.
An antibiotic ointment or drop is usually prescribed to prevent infection. You may be prescribed a pupil dilating drop, which may help to relieve the painful spasms of the iris. Provided you have no medical reason which prevents you from using non-steroidal painkillers, painkillers such as paracetamol or ibuprofen are available over the counter at a chemist or on prescription, and can be used to help with the pain.
Anaesthetic drops are only given to numb your eye in order to help with your examination. They are not prescribed to take home as they will slow corneal healing if used regularly. The time taken for the erosion episode to settle varies from a few hours to a few days.
The only way to avoid recurrent erosions is through the long term use of lubricating eye drops and ointment. Regular use of thick eye ointment at night, and artificial tear drops during the day provides a barrier between the lid and the cornea. This prevents the corneal blister from sticking to the underside of the eyelid. Patients are often advised to continue the lubrication treatment for several months to prevent recurrence even if they do not experience any symptoms.
If you have frequent recurrences despite maximum lubrication treatment on a regular basis, additional treatment options may be considered- such as removing the excess blister tissue from the cornea or fitting a long-term contact lens, known as a bandage contact lens.
Long term complications are rare with recurrent corneal erosion syndrome. Infection may occur, however only very few patients will develop permanent corneal scarring which may affect their vision.
If your eye becomes more red or painful or your sight becomes more blurred, you should telephone Moorfields Direct for advice attend your local A&E department.
Authors: Miss Melanie Hingorani, Dr Swan Kang and Linda Langton
Review date: January 2020