Recurrent corneal erosion primary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]
Primary Prevention
Given that episodes tend to occur on awakening and are sometimes managed by use of good wetting agents, approaches to be taken to help prevent episodes include:
- Avoiding dry or irritating environments (e.g. cigarette smoke)
- Drinking plenty fluids to help prevent drying of the eyes. This may also involve limiting alcohol intake in the evenings. Drinking heavily may cause an episode the morning after, known by some as Drinker's eye.
- Not sleeping-in late, as corneal hydration from lid closure may be a factor affecting epithelial adhesion.[1]
- Use of long-lasting eye ointments (eg lacrilube) applied before going to bed.
- Learn to wake with eyes closed and still. Keep high quality artificial tears within reach at bedtime. If eyes feel stuck shut upon awakening, insert the tip of tears bottle slightly into inner corner of eye, gently squirting the tears, which will seep under the eyelid, often allowing opening of eyes without an erosion episode. Several repeated applications of tears may be necessary, but with patience, eyes will very likely become unstuck allowing painfree opening of eyes and erosion avoidance.
- Another method, after waking with eyes closed and still, is to gently rub the closed eyelids with fingers in a circular motion to unstick the eyelids before attempting to open them.
- Control air quality and humidity while sleeping. Avoid having an over ventilated room while you sleep. Having air flowing over your face, even with your eyes closed, can and will increase eye dryness. Cool, moist and still air is the best environment to prevent unnecessary evaporation of eye moisture.
- Limit your exposure to viruses (e.g. by getting an annual flu shot). Viruses like the flu (and gastro symptoms like diarrhea) seem to cause the eyes to dry out which can contribute to causing an episode.
- Wear glasses (sunglasses, prescription glasses or even fake glasses) especially when engaging in activities like gardening or playing with children.
- Since dryness can be a cause of episodes using the medication restasis to increase tear production is considered a possible means of reducing erosions
- The use of contact lenses may help prevent the abrasion during blinking lifting off the surface layer and uses thin lenses that are gas permeable to minimise reduced oxygenation. However they need to be used for between 8-26 weeks and such persistent use both incurs frequent follow-up visits and may increase the risk of infections.