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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8066
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Severe eye pain, one eye, redness, tearing, cant open eye,

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Severe eye pain, one eye, redness, tearing, can't open eye, last about 45 minutes, Diagnosed with dry eye, pain repeats about every three days, many different otc dryness drops. No help. Re diagnosed with chronic erosive eye. used Muro ointment at bedtime. Pain etc. comes now every morning. Same symtoms.
Submitted: 4 years ago.
Category: Eye
Expert:  Dr. Rick replied 4 years ago.

Dr. Rick :

Hi. I'll be happy to help you with your question this morning.

Dr. Rick :

In the past did you have any trauma to your eye, such as being poked with a fingernail etc?

Dr. Rick :

I see that you are online, are you available to chat?

Dr. Rick :

I guess you must not be near your computer. I will switch to Q&A format so we can continue our discussion.

Expert:  Dr. Rick replied 4 years ago.
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Customer: replied 4 years ago.
No. none that she remembers.
Expert:  Dr. Rick replied 4 years ago.

It sounds like you are suffering from recurrent corneal erosion syndrome (RCES). What's that you might ask?

 

Recurrent corneal erosion is a condition where, usually after some type of trauma, the epithelial layer of the cornea ("skin") no longer attaches to the underlying tissue (bowman's layer) and keeps coming loose. Think it as a piece of velcro, with the epithelium and bowman's layer as the two strips. In recurrent corneal erosion syndrome the little "hooks" in the velcro are broken. RCES can also be seen as a secondary result of another disorder, such as map dot fingerprint disease.

Customer: replied 4 years ago.
That was explained by the last opthamologist . She prescribed blink. and if that didn't work go to muro ointment at night and systane during the day. Systane irritated the right eye, and muro caused the attack to go from once every two to three days at about 3-4 am, to once a day about 6-7 am in the morning. Eye was extremely red and teary the pain slowly diminished and red was reduced within and hour. I think the hypertonic NACL oint is causing more problems on its own.
Expert:  Dr. Rick replied 4 years ago.

Sorry, I got called away from the computer in the middle of my answer....I'm back now

 

Expert:  Dr. Rick replied 4 years ago.
Drops and ointment are the first line of treatment. The next step is the use of a bandage contact lens at night along with the natural tears. This helps to prevent the epithelium from sticking to the inside of the eyelid, although just taking out the contact can cause an erosion. The next step in anterior stromal puncture. This is where the ophthalmologist uses a bent 25 ga needle and makes little punctures in the cornea. This is thought to help by allowing the hemidesmones (velcro hooks) to attach better. I would not recommend this is the erosion is in the center of the visual axis as it can leave a small scar.
Expert:  Dr. Rick replied 4 years ago.

the next step in treatment is phototherapeutic keratectomy with a laser (PTK). This is the same laser used in Lasik, but used in a different way. In PTK the epithelium is removed from the cornea and the laser is used to remove part of the cells in the corneal stroma. It is thought to work by stimulating the natural regrowth of cells such that these new cells can better attach to the epithelium and prevent RCES.

 

Since your symptoms have gotten worse with first line treatment you should speak to your ophthalmologist about the other options I've outlined above.

 

I hope that this information was helpful for you. Please, allow me get credit for my time and effort in assisting you and press the ACCEPT button for this assist. I will be glad to answer additional questions until you are satisfied. Thank you very much.

Postive Feedback and/or Bonus is welcomed and appreciated.

Customer: replied 4 years ago.
That was explained by the last opthamologist . She prescribed blink. and if that didn't work go to muro ointment at night and systane during the day. Systane irritated the right eye, and muro caused the attack to go from once every two to three days at about 3-4 am, to once a day about 6-7 am in the morning. Eye was extremely red and teary the pain slowly diminished and red was reduced within an hour. I think the hypertonic NACL oint is causing more problems on its own.

She just tried the drops and there was no burning and after 20 minutes no eye irritation. When she puts the ointment in her eye it stings. When she woke up at 3:00am she added more ointment on the second day.
Pain and eye irritation repeat took three hours from last application. Her MD will not be available till monday morning. Should she try the hypertonic NaCl till then?
Expert:  Dr. Rick replied 4 years ago.

I think the most effective thing to do until Monday would be to use the ointment a lot, even during the day. The Muro128 ointment has a high salt content which pulls the moisture out of the cornea and, hopefully, helps the epithelium to "suck" down on bowman's membrane better. It stings because of its hypertonic nature.

 

If the muro128 stings too much to use you can use lacrilube ointment, which you can buy at almost any pharmacy/walmart etc. This ointments primary function will be to lubricate your eye and keep the weak epithelium from touching anything, like the inside of your eyelid, and hopefully prevent an erosion. Using an ointment all day long will, of course, blur your vision but hopefully it will goop things up enough to protect your corneal epithelium until you can see your ophthalmologist on Monday.

 

I am still online and will be happy to respond to your posts right away.

 

I hope that this information was helpful for you. Please, allow me get credit for my time and effort in assisting you and press the ACCEPT button for this assist.
Positive Feedback and/or Bonus is welcomed and appreciated.

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8066
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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