somewhat daily mutterings

/Miscellany Corneal Abrasion Time (Ugh)

From time to time, I get a corneal abrasion at night, when the epithelial layer sticks to my eyelid. I then move, or open, my eye, and a bit of the epithelium is torn away. This hurts. Badly. It's like having someone pour sand into your eye. The tearing is non-stop, and your eye hurts a lot whether it is open or closed. Most of the time, I can go back to sleep and by the time I awake, it's healed, or at least reduced in intensity. However, once in a while it is disabling. Last Thursday was one of those times.

It's usually my right eye, as it was this time. The abrasion was right in the center of my cornea, so I couldn't see very well out of the affected eye. I also must have dumped a gallon of tears out of the eye by mid-morning. When it's this bad, I go to the optometrist to have them look at it, which I did Thursday morning. The Optometrist recommended an antibiotic drop and, because this is a recurring problem for me, a nightly application of Muro 128, which he says puts the eye in "defense mode" and hopefully shores up the repairs that the eye normally makes.

By Thursday afternoon, the pain was gone, but I still couldn't really see out of my right eye. Still, I was relatively comfortable. Thursday night I applied the Muro 128, which stung quite a bit, but this, according to the instructions, was to be expected. Unfortunately, over the course of Friday my eye felt worse and worse. By the time I left work, it just didn't feel right at all. I applied the Muro 128 again and went to bed early. Saturday, my eye felt (and looked) horrible. It was tearing a lot, red and angry looking, and I hurt a lot when my eye changed focus, or when looking at something even moderately bright (photophobia). I scheduled another trip to the optometrist -- same shop, different guy. He looked at my eye in more detail than on the first visit, and looked a little alarmed once he'd done so. He gave me a "good news, bad news" story: "there's no infection, but the abrasion covers a very large area - three to four millimeters. It could take a while to heal, and may not heal very well, at that." We discussed the option of going to an opthamologist, and agreed to wait until Monday if necessary at all. He and I agreed to drop the Muro 128.

The rest of Saturday my eye was pretty sore. Nothing was very comfortable, so I finally put some antibiotic in my eye, and took a nap. When I woke up, the difference was amazing. My eye felt much, much better, and my vision was somewhat restored. However, there seemed to be a filmy something or other in my eye that would somewhat occlude my vision. It also felt as though a hair was in my eye, especially when my eye was closed - annoying but not painful. I looked closely in the mirror and could make out a thin "skin" of material stuck to my cornea. I could see it slide around and sometimes get a bubble under it as I blinked and/or moved my lower eyelid around. I was a bit alarmed, so I called the optometrist, who'd given me his home number. He didn't seem to concerned, and told me to sleep on it and see how it looks in the morning. Later in the evening I took another nap, with more good results. I finally went to bed around 10:00 with an application of only the lubricating drops. This morning, I'd guess my vision is around 95% and my eye feels about 90%. What an improvement!

Even though my eye is feeling good, I still plan to see an opthamologist. I want him to take a good close look at my eye and give me a prognosis for the long-term. The optometrist theorized that the film that I saw Saturday night was the epithelial layer rebuilding. However, I always picture this happening as a migration of cells, rather than a building of a "skin" that is then cemented down. I guess I worry that this new skin won't adhere as tightly as it needs to, and I'll just rip it loose again. I also wonder if the "skin" is just the remains of the original layer that was torn loose. Perhaps I need a debridement to really clean the area up and get a good, tight regrowth. I don't look forward to having that done, but if it can prevent future problems it's worth it.

Posted: Sun Mar 28 10:56:34 -0800 2004

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