Oculase Articles

How long does recurrent corneal erosion last?

Mr Tariq Ayoub - 22 Dec 2022

If you have recurrent corneal erosion (RCE) syndrome, you might wonder how long it’s likely to last. In this blog, we cover how long it may take to heal, the process of corneal healing, and the prognosis of RCE. Oculase’s eye specialist, Mr Tariq Ayoub, is an expert in treating corneal conditions. Contact us today to learn how he can help you. 

What is recurrent corneal erosion? 

RCE is a common condition that affects the cornea (the clear film covering the eye). If you scratch your cornea and the outer layer doesn’t heal correctly, it can cause a blister. The blister’s surface can stick to the inner surface of your eyelid when you are sleeping or have been in a dry and/or dusty environment. 

When opening your eye, the blister can burst or tear, causing the damage to reoccur. This may cause severe eye pain and watery eyes at night or first thing in the morning. It may also cause other symptoms, such as: 

RCE can also be caused by certain corneal dystrophies, such as lattice, granular, and Reis-Bucklers. In people with corneal dystrophies, the front part of the cornea may be diseased, so it struggles to heal when damaged. 

Previous eye surgery can be a risk factor for RCE. If you are worried about your risk of RCE after having had eye surgery, speak to your medical specialist about any concerns you may have. 

Sometimes, RCE is spontaneous, although this is rare. 

How long does RCE take to heal?

Corneal erosion may take from 24 hours to up to a week to heal. If you have RCE syndrome, you may experience frequent episodes over weeks, months, or even years.  

You may have injured your eye a few weeks, months or even years before the initial erosion. We call this a trauma. Improperly healed trauma to the eye is the most common cause of this disorder. The first recurrent episode may occur a few weeks after the initial erosion. 

How many times can I experience RCE?

The number of episodes you may experience can differ from person to person. Some people experience a few erosions a year, while others have episodes multiple times a week. Due to environmental factors, your symptoms may worsen at specific times of the year. 

If you have dry eye syndrome and have had a previous eye injury, you may be at higher risk of frequent erosion episodes.  

Other conditions that can make you vulnerable to frequent episodes of RCE include blepharitis, type 2 diabetes, and ocular rosacea. 

Our highly-trained ophthalmologist will inform you of your treatment options, such as lubricating eye drops, to prevent episodes and help the cornea heal. We explain this further in our blog: What are the treatment options for recurrent corneal erosion syndrome? 

Corneal healing

Many factors can affect how the cornea heals and whether it heals correctly or quickly. These include some conditions and lifestyle factors, such as diabetes and smoking. Corneal healing occurs over four stages, which may overlap: latent, migration, proliferation, and epithelial reattachment. 

Latent (or lag) stage – this involves cell changes. During this phase, damaged epithelial cells (a type of cell that covers the inner and outer surfaces of your body) undergo programmed cell death (apoptosis) and enter the tear film that covers your eye’s outer mucosal surfaces. This stage usually takes a few hours. 

Migration stage – this refers to the movement of cells as they cover the affected area. The size and location of the corneal injury can influence how fast this happens, but it is often between 24 and 36 hours. 

Proliferation stage – once the cells have migrated, they multiply (proliferate), and the thin cell layer thickens to restore regular epithelial thickness. The cornea’s barrier function is also repaired. 

Reattachment stage – in the final stage, the epithelial cells re-adhere to the basement membrane (epithelial reattachment). This process should take a few days if the basement membrane received no damage. However, if the basement membrane is damaged, this can take several months or longer. 

We understand that the extended healing time can be daunting and could cause you distress. Feel free to ask our ophthalmologist any questions about your condition and its recovery so we can help ease your worries. 

Prognosis

If you follow the proper preventative measures, the prognosis with the right treatment is excellent. After a thorough assessment, our ophthalmologist will recommend the most suitable treatment method and educate you on how to prevent RCE.  

Alongside treatment, you’ll need to ensure that any underlying conditions, such as diabetes, are well managed. Your GP should be able to help you with this. Any condition contributing to ocular surface disease, such as dry eyes and blepharitis, must also be adequately managed. 

After RCE resolves, some people still occasionally experience early-morning foreign body sensations. To prevent another recurrence, continue to use lubricating ointment before bed for at least six months after your symptoms stop. 

Complications of RCE

Frequent episodes can lead to corneal scarring, but this is rare. Scarring can occur after a corneal infection. RCE increases the risk of corneal infection, although it can also be caused by it. Other possible complications include infectious keratitis and corneal haze. Corneal scarring and infectious keratitis can affect your vision, though this should improve with treatment. 

RCE is not usually an emergency, although it can be painful and disruptive. However, if you have eye pain alongside the following symptoms, we would recommend seeking urgent medical attention: 

  • Headache 
  • Foreign body sensation 
  • Fever 
  • Nausea and vomiting 
  • Irritation or redness that you can’t explain 
  • A cut, scratch, scrape or puncture injury to your eye 
  • Sudden vision loss 

Prevention 

RCE can be unpredictable, but there are ways to prevent it from occurring. This includes: 

  • Wearing eye protection if there is a chance of eye injury 
  • Lubricating the eye with artificial tears, gel or ointment – this can prevent the eyelid from sticking to the corneal surface, which can contribute to erosion 

Book an appointment

A diagnosis can make you feel stressed and keen to fix it with treatment. At Oculase, we know you need to fully understand your condition to make an informed decision about your care.  

Mr Ayoub has completed a prestigious corneal fellowship, which has provided him with a wealth of knowledge on corneal conditions and their treatment options. We form a detailed treatment plan with you, considering your wants and needs every step of the way. Put your eye health first and book a consultation with our expert ophthalmologist. 

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About the author

Mr Tariq Ayoub
Mr Tariq Ayoub, Consultant Ophthalmologist

Mr Ayoub has been rated as one of the top eye surgeons in the UK. He is a Consultant Ophthalmic Surgeon with Imperial College Healthcare NHS Trust in London, one of the largest NHS trusts in England. He is also the Lead for the Emergency Department at Western Eye Hospital, as part of the Imperial College Trust.

Mr Ayoub completed his Ophthalmology training at the prestigious London School of Ophthalmology, namely at Moorfields Eye Hospital and Royal Free Hospital. During his career, he has received many prestigious awards from national and international organisations for his work in the field of ophthalmology.

His clinical interests include treatment for cataracts, vision correction, corneal disease, eye-lid disorders, trauma, and general ophthalmology. Mr Ayoub prides himself on the high quality of his work. With his extensive experience, he can holistically manage complex eye conditions to deliver the best care for his patients.

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