Recurrent Corneal Erosion
Recurrent Corneal Erosion 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. Our Corneal Specialists 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 where the epithelium is either gently removed, or microscopic "spot welds" are made on the cornea to encourage the epithelial layer to bond securely to Bowman's Membrane.
Patients, who continue to suffer from Recurrent Corneal Erosions despite the treatments described, may benefit from Phototherapeutic Keratectomy (PTK). This involves removal of the superficial layer of corneal cells using the Excimer Laser to encourage proper healing.
Pterygium
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. Occasionally they need to be removed. Removal of a pterygium is a surgical procedure that has recently undergone medical advances. As Corneal Specialists, our doctors use a surgical technique with conjunctival thin-strip autographing 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.
Dry Eyes
Dry Eye Syndrome is a very common eye condition that can affect the cornea. Anytime there is inadequate tear production, too rapid tear evaporation or drainage, the symptoms of dry eyes may become present. The symptoms of dry eyes include a scratchy, dry, sandy or gritty feeling that can be accompanied by a stringy clear white discharge with noticeable pain and redness. Dry eye creates additional risk of corneal infection, as the tear film, which serves a protective mechanism and contains a number of antimicrobial components, is deficient.
Fortunately, our team of doctors has a great deal of expertise in the advanced diagnostic testing of dry eyes and will be able to make a treatment recommendation for your individual situation. For those patients with mild to moderate dry eyes the first course of treatment may be to use unpreserved artificial tears or lubricant eye drops. Depending on the nature of your tear film deficiency, they may prescribe a specific type of artificial tear that has different characteristics in terms of salt content, viscosity or lubricity.
In addition, it may be necessary to insert tiny “punctual plugs” into the openings of your tear ducts, in order to slow down or even stop the drainage of tears from the eye. Occasionally there are some cases that may not respond to the above sequence of treatment options because of some underlying low-grade inflammatory or infectious process. In these cases it may be necessary to also prescribe an oral antibiotic such as a tetracycline or an anti-inflammatory eye drop such as a corticosteroid eye drop.
If you suffer from moderate to severe dry eyes they may prescribe Restasis® eye drops, which in addition to the other treatments can often help alleviate your symptoms. Restasis® is an advanced type of cyclosporine eye drop that acts by blocking a specific type of inflammatory cell from entering the Lacrimal Gland, which produces normal tears. By reducing or blocking inflammation in the Lacrimal Gland, it functions much more effectively so that you can actually make more of your own natural tears and keep your eyes moist and lubricated.
Early Diagnosis and Treatment Is Essential
As you can see there are many conditions that can affect the cornea. Cornea Consultants doctors can often treat most of these eye conditions and corneal diseases using non-surgical treatment options. However if they are not diagnosed and treated early or if they progress to where vision is compromised beyond an acceptable level, it may be necessary for our Corneal Specialists to perform a Corneal Transplant.
Alabama Eye & Cataract Center, P.C. Birmingham Corneal Specialists Marc Michelson M.D. and Tyler Hall, M.D .provide diagnosis and treatment of Corneal Conditions including Recurrent Erosion, Pterygium, Stevens-Johnson Syndrome and Dry Eye and are conveniently located for patients from Birmingham, Mountain Brook, Vestavia Hills, Hoover, Fairfield, Midfield, Alabaster, Bessemer, Adamsville, Forestdale, Fultondale, Gardendale, Center Point, Trussville, Leeds, Moody, Tarrant City, Childersburg, Anniston, Gadsen, Pell City Montgomery, Auburn, Dothan, Prattville, Millbrook, Tallassee, Tuskegee, Tuscaloosa, Northport, Lakeview, Coker, Cottondale, Peterson, Brookwood, Holt, Green Pond, Woodstock, Bucksville, Taylorville, Duncanville, Huntsville, Decatur, Madison, Florence, Athens and Hartselle, Alabama. To learn more or schedule an appointment call us at 205-930-0930.
