Corneal Erosion
This disorder follows initialtraumato the surface cornea, such asthe
fingernail of a child carried in the parent’s arms, a spiked-leaf palm tree, or
a branch that snaps back on to the eye. Properly treated, this epithelial
defect usually heals within a short time, i.e., 24 to 48 hours depending on the
size of the defect. However, occasionally
the epithelial cells do not properly adhere to Bowman’s layer so that the
epithelium repeatedly ruptures at the site of the initial injury. This
characteristically occurs in the morning when the patient wakes up and suddenly
opens his or her eyes. This recurring
ero-sion often creates severe emotional stress for the patient.
Immediately after the injury,the patient
experiences a severe foreign-body sensation associated with tear-ing. Because
there is actually a defect in the surface
of the cornea, the patient has the subjective sensation of a foreign body within the eye. The epithelial defect
causes severe pain, which immediately elicits a blepharospasm. Addi-tional
symptoms associated with corneal erosion include immediate eyelid swelling and
conjunctival injection. Fluorescein sodium dye will readily reveal the corneal
defect when the eye is examined through a blue light (Fig. 18.5).
An antibiotic ointment eye bandage is used.
Treatment of recurrent corneal erosion often
requires hospitalization. Bilateral bandages are placed to ensure that the eyes
are completely immobilized.
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