The challenge with RCEs is how to get the cycle under control, reliably protect the cornea against new erosions, and if possible heal and compact the epithelium to the point where with reasonable care recurrence can be avoided. Here are some of the methods that are employed to discourage recurrence:
- Hypertonic ointment (Muro 128).
- Dwelle®. [NOTE: Dwelle is not a prescription drug, its classification for FDA purposes is "just" an OTC lubricant eyedrop, but we have had extensive reports over the years from people who have used it to control erosions and some well-known corneal specialists regularly prescribe it for this use. We highly recommend reading materials by formulator Dr. Frank Holly about high oncotic pressure eyedrops and their mechanism of action.]
PHYSICAL BARRIER PROTECTION:
- Tranquileyes moisture goggle.
- "Bandage" contact lens. These are often used to treat an individual abrasion/erosion but in severe cases are also used nightly as a protection against future erosions.
- De-epithelialization (removal of the epithelium), either manual debridement or with a laser (called PTK or phototherapeutic keratectomy).
- Stromal puncture
Great big huge disclaimer, don't do anything I suggest without consulting your doctor, follow your doctor's instructions and not mine, please don't sue me, etc. etc.
(1) The following strategy, faithfully employed over a period of months, seems to have worked quite well for a lot of people that I know with RCEs - subject to many variations on the theme of course! (a) Rice baggy compress before bed. (b) Dwelle drops applied night (reapplied during the night if necessary), morning, and - especially in the first several weeks - two to three times during the day. (c) Tranquileyes moisture goggle or similar (if necessary, tape).
(2) Taking pains to prevent sudden eyelid opening during the night or on waking can make a real difference to the occurrence of erosions, as sudden lid opening can trigger an erosion. Please visit DryEyeTalk for tips about this - patients have various strategies for it. Some wear moisture goggles or a sleep mask, others moisten their lids and wait awhile before opening their lids.
(3) I think that bandage soft contacts are under-employed in treating erosions when they're at an acute stage. If you haven't been offered this option, you may want to discuss it with your doctor.
(4) Be very cautious about considering invasive treatments - make sure you've really exhausted other options before going the surgery route and make sure you understand the limitations and risks.