Friday, April 30, 2010

Recurrent Corneal Erosion Syndrome

I have to go to bed earlier.  And it has nothing to do with my beauty sleep.  My eye is falling apart.
Sometime around April or May, 2009, the dust storms had started and it was continually hazy in our region of the Middle East.  I started waking up periodically with what felt like a massive, sandy boulder in my right eye.  It usually started about 5 or 6 AM and would cause me to bolt upright in pain, tears streaming from my eye as my body tried to reject whatever invader had attacked my sight.
I thought it had to be the sand in the air getting in our room, but it continued after the atmosphere cleared.  Not every morning, just every so many days.  A week or two would go by and suddenly, I’m pawing at my face at some ungodly hour as the call to prayer echoes through the valley.
We left Jordan, returned to the States, and it continued; that’s when I realized I had problem.  My mom and I started comparing notes.  A few years earlier, she had encountered the same symptoms.  She went to an ophthalmologist, who told her she suffered from Recurrent Corneal Erosion Syndrome.  The only way it can be diagnosed is through a special dye or a slit-lamp microscope.  Using these techniques, the doctor can see patterns across the cornea, like a map or scratched glass indicating separation.
The basic concept is that the top layer of cells on the cornea start to slough off, like a hangnail.  This exposes the nerve endings underneath and causes you to want to rip your eyeball out of the socket.  Once the layer gets “glued” back down, the pain goes away, but that can take (in my experience) an hour or more.  Here’s the crazy thing:  The body’s natural tears are too “wet” to get the layer back in place, so you have to use a product with a stronger adhesion and less saline.  I went to see the same doctor, explained my situation and he gave me some sample drops of some fancy stuff.  Upon application, everything goes blurry for a bit, as if you’ve poured oil in your eye.
So, why does it only happen in the morning?  The body hits an REM sleep cycle around that time.  The eye has dried out overnight and as movement increases, the layer begins to snag and pull away.  As the pain increases, the eyelid instinctively snaps open and drags the layer free.  With each successive blink of the dry lid, the layer flaps back and forth giving the impression of matchstick rubbing under your eyelid.
Yeah, it’s painful alright.  And it’s difficult to get back to sleep.  You don’t want to close your eye because any sound causes the closed eye to move in that direction which only adds to the irritation.  Basically, you have to focus your attention on a particular spot in your mind and hope the layer reattaches, otherwise you’re up for the rest of the day.
The solution? Get some rest and avoid stress.  The longer the eyes are open and not blinking (thus washing the surface) the more the eye will dry out in the night.  It also helps not to sleep too late as it allows the eye to dry even longer.  The experts also recommend keeping hydrated and avoiding excessively dry, overheated environments (um... like the desert?); as well as learning to wake slowly without much eye movement to allow the eye gently open without tearing the corneal layer.
There are medical fixes for it, and Wikipedia’s got some resources to follow. For a serious case of RCES, read this poor dude’s blog entry.
I promise, every time this happens to me, Ben Stein's at the foot of my bed going, "Drrry Eyyyes." Between him and the asteroid under my lid, 'bout makes a guy go nuts... or hit the sack sooner.

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