Recurrent corneal erosion syndrome.

Recurrent corneal erosion syndrome is a chronic relapsing disease of the corneal epithelium characterized by repeated episodes of sudden onset of pain usually at night or upon first awakening, accompanied by redness, photophobia, and watering of the eyes. Individual episodes may vary in severity and duration. These symptoms are related to corneal deepithelialization in an area in which the epithelium is weakly adhered. It is a frustrating disorder for both the patient and the physician. In the majority of cases, the acute episode is managed by patching, and cycloplegic and topical antibiotic ointment, with prophylactic application of gels during daytime and ointment at night to prevent further erosion. In a minority of cases these measures are insufficient and may need alternative treatment modalities including therapeutic contact lens wear, anterior stromal puncture, superficial keratectomy, Nd:YAG, and most effectively, excimer laser therapy (phototherapeutic keratectomy).