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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11367
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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When I open my eyes in the am I sometimes feel like a

Customer Question

When I open my eyes in the am I sometimes feel like a scratching or the skin is tearing away on the top of my eye ball and also feels like sand. I've tried warm compresses prior to opening my eyes etc but still have this. It does not happen every day but at least 4 times a week. This has been going on now for 6mos. I am 59 year female. I have also noticed that my skin on my face only is extreamly dry and feels like sandpaper. What's going on? Please help.
Submitted: 6 years ago.
Category: Eye
Expert:  Dr. Rick replied 6 years ago.
Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

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.

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 is 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.

Dr. Rick :

I suggest you make an appointment with an ophthalmologist in the near future for a full exam.

Dr. Rick :

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Expert:  Dr. Rick replied 6 years ago.