Hi. I'm online and happy to answer your question today. Thank you for the extensive post.
From what you have posted, I have to agree with the second ophthalmologist
: You most likely are suffering from recurrent corneal erosion
As an aside, you should NEVER use anesthetic drops for persistent eye pain. This can cause very serious eye damage...up to and including loss of the eye. This drop should only be used in the ophthalmologists office....
So. Let me tell you a little bit more about what I think is going on in your eye....
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.
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 treatment is anterior stromal puncture. This is where the ophthalmologist uses a bent 25 gage needle and makes little punctures in the cornea. This is thought to help by allowing the hemidesmosomes (Velcro hooks) to attach better. I would not recommend this if the erosion is in the center of the visual axis as it can leave a small scar.
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.
Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?
I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. And please let me know if the rating system gives you any troubles.
Thanks in advance,
Dr. Rick MD FACS