Recurrent Corneal Erosion Syndrome (RCES)

We have included this information page because RCES occurs quite commonly, and succesful treatment and prevention relies heavily on home management.

What is it? RCES commonly occurs after a corneal abrasion - a scratch to the front surface of the eye. This scratch heals, but the surface of the eye is very fragle, and susceptible to (ongoing) erosions. These erosions are exceptionally painful, and typically occur at night or first thing in the morning. Whilst the pain can subside after a few hours, it can be rather debilitating as the cornea is so sensitive.

Treatment is intense lubrication with eye drops and ointment before sleep. Use of nightime ointment should be ongoing for several months at least. Keeping the surface of the eye protected gives the best chance for this fragile cell layer to become stronger.

Why does RCES occur in the morning? This is when the eye is at its driest, after hours with no blink action to create and maintain the vital protective tear film.

It can be very helpful to have a careful routine around how you open your eyes in the morning. To start don’t just wake up and open your eyes! Leaving your eyes closed while you activate your tear film can be very helpful to preventing episodes. Start by squeezing the eyelids together very strongly a few times - don’t open yet.

With your eye closed move your eyes through up and down gaze a few times. If you can use a warm compress even better - navigate to your bathroom with closed eyes, or have someone deliver a warmed wheat bag or flannel to you. Or rub your hands together briskly then hold your wrm palm against your eyelids. The purpose of all this is to stimulate secretions from glands in the eyelids and the surface of the eye.

If you do experience an episode, lubricant drops may be helpful. Take oral pain relief. Be prepared for the eye to be very light sensitive for a few hours. Most importantly though, jump back into a diligent routine about nightime ointment and stick with it.