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Re: Corneal Erosion
Feb 15, 2006
[QUOTE=Jonny412]Anyway, isn`t dry eye a factor in RCES? I mean you all are putting in liquid tears...[/QUOTE]

Actually they really are very very different. In fact, you should search the healthboards for a dry eye syndrome thread because I'm pretty sure there are some and as I recall with dry eye syndrome things do tend to get worse as the day goes on (unlike RCES). We do use artificial tears BUT that is really something done right when awakening. You see, with RCES what happens is some may sleep with their eyes slightly open which will dry the eye out at night. Also, people's eyes do not produce tears when they are asleep (this goes for everyone). But, in the morning, when those with RCES awaken, the action of blinking causes the cells to get "wiped off" or "erode" away. But, it's not just the dryness that does it. RCES is considered a failure of the epithelial cells to "stick down" and hold. That is the key thing. So, when one awakens and first blinks, they are most vulnerable to the cells being sloughed off. The movement of the eyelid across the eye causes the cells to get "sloughed off" and/or erode away...the cells fail to "stick down." Then things get better as the day goes on (because the adjacent epithelial cells fill in the gap) and once night hits they start to realize they could be "in for it" again when morning comes. Soon RCES sufferers begin to fear going to sleep for they know what awaits them when they awaken in the morning.

I believe that if one learns to lubricate their eyes with artificial tears before moving their eyelid (when first awakening in the morning) it prevents the cells from being sloughed off because the extra lubrication allows the eyelid to move and allows the eye to begin producing its own natural tears without causing the cells to slough off. This gives the epithelium more time build back up again which promotes long term healing.

Regarding bandage lens - they are good for pain when "healing" but it's true that it makes one far more susceptible to an infection (probably because everything gets trapped between the eye and the lens).

Have you tried warming and then applying Muro 128 ointment during the day - or any ointment? That may help. Ointments last a lot longer than artificial tears. I'm not sure what you have but it sounds to me like you are going to have to keep searching. Perhaps there is an eye institute near you and there are specialists you can seek out to help diagnose what is going on.

Best to you,
Mike
Re: Corneal Erosion
Feb 17, 2006
Again - you should try Doxycycline. Physicians prescribe it for dry eye as well as RCES and a number of other occular surface problems. I think what your doctors do not understand is that Doxycycline has special properties not related to their antibiotic purposes. It has been shown that within 2 months Doxycycline reduces the MMP enzymes in the eye up to 70%. The MMP enzymes prevent the epethelial cells from properly adhering to the base membrane. Doxycycline has been shown to also promote proper tear formulation. Your Zymar won't do any of that - it will only fight off infection.

Regarding filaments - I recently read an article that "pulling filaments" off the eye causes redness and risks infection and other possible problems. Bandage lens should be short term since again one risks infection. The method of choice for that...again is Doxycycline.

Doxycycline is so inexpensive, widely available and easy to get. You can even get it for acne as well as a wide range of bacterial infections. But, as I said, it is only the "cyclines" that inhibit the MMP's. This has nothing to do with bacteria. This is a relatively recent discovery (within the last year or two).

My 1-2-3 advice is 1) Doxycycline 2) Warmed Muro ointments during the day and at night 3) Artificial tears right upon awakening before moving your eyes.

But of course it's up to you and your doctor the course of action you take. I just think that if things are not working you have to change things to find out what will work. I've been down that route with doctors who just do the same thing over and over even when things are not working. What good is that (maybe for the doc's pocketbook)?

Best to you,
Mike
Re: Corneal Erosion
Feb 17, 2006
[QUOTE=Jonny412]Mike,

These are the questions. Please answer, thanks.

1. Have you or anyone else on this thread that you know of had filaments on the eye?

2. Have you or anyone else on this thread that you know of found temporary complete resolution with a bandage contact?

I checked and I can take that anitbiotic.[/QUOTE]

1. As far as I know - I don't have filaments. You may want to search the entire healthboard forum for something like filaments and eye and see what comes up. I have read that doxycycline may help and it's great that you can take it. Any of the "cyclines" are good but I think doxy seems to be the one of choice.

2. I don't know of anyone who has. I used to be pro on the lens now I'm against it for two reasons. First, to trap the cornea under a bandage lens clearly makes infection more likely. Short term - after an injury for pain it's "okay" but infection is more likely. I question whether a patch might be a better way to go. Would make a great research paper for someone. Second, it could have long term complications. Consider the fact that you are starving a "compromised" cornea of oxygen.

People should know that the eye is deprived of oxygen when wearing a bandage or any other contact lens. If the lens is not taken out regularly, the eye will make new pathways (arteries) below the cornea to supply it with oxygen. This could affect vision and also "could" be a problem if you have filaments...I don't know but it would make me have second thoughts about a bandage lens when there are other options available.

I too wanted to wear a soft lens. But, this was recent and for different reasons. I wanted to get rid of the glasses. It wound up not correcting the way I wanted and the doc said I would have to take them out every night and it just wasn't worth it.

I know that when you explore option after option - it's almost like you find out all these things that don't work. But, once you find just a few things that work for you - that's all it takes. Glad to hear you can explore doxy as a possibility.

Hope that helps.

Mike





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