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Waking up with eye pain--Recurrent Erosion

Does the following sound familiar? You wake up in the morning or the middle of the night for a snack and you start to open your eyes and they feel stuck together? Maybe you have to slowly open them or move your eye around while they are closed or sneak some drops in there just to get them open. You may open them quickly and experience a severe tearing pain. This pain may last for minutes, hours, or even days. Sometimes you may be afraid to open your eyes period. All the previous descriptions are of recurrent erosion syndrome. This is a condition where the cornea (the front clear layer of the eye that you see through) has a tear of the superficial tissue called the epithelium. It is typically related to a prior injury or a genetic predisposition, and can be very painful. It can often significantly degrade the quality of life for the sufferer. If you have a corneal abrasion or a prior eye surgery, the surface tissue may not heal very well and become loose. Overnight, the eye typically drys out and the eyelid will stick to this loose tissue. When you wake up and open your eyes, the eyelid will tear that tissue from the surface of the eye. This is typically extremely painful because the cornea is the most sensitive area of the body with approximately 7000 pain nerves per square millimeter. Other causes of this condition include map-dot-fingerprint dystrophy (also known as anterior basement dystrophy or epithelial basement mebrane dystrophy, etc). This is an inherited condition in about 5% of the population, but often does not cause any symptoms. With age, the surface layer tends to get folds in it, and not stick as well to the underlying structure of the cornea. People with this condition may get tears with no predisposing factors, and may have blurry vision from folds in this tissue. There are many possible treatments for this syndrome. Typically, I will start with hypertonic ointments like Muro 128 at night. If this does not work, I may consider bandage lenses, steroid drops, or doxycycline. Sometimes the eye is very dry and that needs to be addressed first. There are also several low risk surgical procedures that can be undertaken either in the office or operating room that have a high rate of success for this condition. They only take a few minutes to perform and often cure the condition or send it into a long term remission. If you have recurrent erosion in central Texas, Waco, the Austin area, or Georgetown, please contact our office at 512-686-1224 to schedule an evaluation with Dr. Aaker.

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