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Recurrent Erosion Syndrome

What is recurrent erosion syndrome (RES)?

Recurrent corneal erosion syndrome (RES) is diagnosed when a person wakes up in the morning with a very painful eye, which feels like something has “ripped” on the surface of the eye. An abrasion or corneal ulcer develops when the epithelium (skin) on the surface of the cornea is dislodged.

 

What causes it?

The most common cause of recurrent corneal erosion is a fingernail injury or other trauma to the cornea. It can also occur spontaneously, or in patients with a weakness of their cornea called Map Dot Fingerprint (Epithelial Basement Membrane) Corneal Dystrophy.

What treatments are available for recurrent corneal erosion syndrome?

There are 3 main treatments:

  • Lubricating ointment at night-time and drops during the day. Sometimes oral antibiotics to improve Meibomian gland dysfunction and reduce tear enzymes are recommended. Lubricating ointment will prevent the eyelid from sticking to the epithelium and lifting it off the cornea.
  • Bandage contact lens, used under close medical supervision, changed monthly for at least 3 months.
  • Laser phototherapeutic keratectomy (PTK). Laser PTK is performed by removing the epithelium (or outer skin of the cornea) and then applying excimer laser treatment to the surface of the cornea. The goal is to produce a smoother and clearer cornea, and to enable the epithelium to bond better to the rest of the cornea to prevent recurrent erosions.

 

What happens during PTK surgery?

Anaesthetic eye drops are used to numb the surface of your eyes. A clean drape will be applied around your eye, and a gentle eyelid clip will keep your eyelids open during the procedure.You will be asked to look a target light while the epithelium, a thin layer of protective skin that covers the cornea, is removed with a fine spatula. The laser will then treat your cornea. It is important to continue looking at the target light whilst the laser treatment is taking place. The laser treatment will be finished in less than a minute or two, depending on the amount of treatment needed. Your eye will then be examined by Miss Saw at the slit lamp microscope. Sometimes a little more laser treatment will be done that day, until the cornea is smooth and clear. A bandage contact lens will be place in the eye at the end of the procedure. 

What happens afterwards?

Your vision will be blurry or hazy for the first few days. You will experience some discomfort as the epithelium heals and covers the treated area. Your eye will be gritty, red, watery and sensitive to light, especially during the first week, but this will gradually improve. Cool compresses, regular pain tablets and eye drops will be used to minimize this discomfort. Sleeping will help the eye to heal. You will either use an eye pad for 2 days, or use a soft bandage contact lens for up to 1 week. Most patients resume normal activities after the first week, sometimes earlier. Vision can fluctuate for up to six months.

What are the risks of PTK?

PTK is a safe and effective procedure, but like any surgical procedure, it does have some risks and side effects. Some patients find that their spectacle or contact lens prescription is slightly different after the procedure. After PTK, it is normal to experience light sensitivity, glare and halos. These visual side effects are mild and temporary and have a tendency to resolve over time. When treating recurrent corneal erosions, PTK may need to be carried out more than once. Serious complications following PTK are extremely rare but include corneal infection, irregular astigmatism (where contact lenses may be needed to improve vision which cannot be improved with spectacles), or permanent scarring which impairs the quality of vision.

 

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    David Sindall

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    Katie Price

  • The treatment was completely successful. Great to be able to drive without glasses and to buy sunglasses without having to get expensive lenses. Wish I’d done it sooner, best money I’ve ever spent!

    Niroshini Gallacher

  • The initial examination was thorough beyond all previous experience and her advice complete, informative and very reassuring. Taking the plunge I elected to have lasik surgery and the procedure was duly completed without pain in a calm and comforting environment by a scrupulously professional team led by Valerie. Despite the recent surgery there was an immediate and staggering improvement in my vision and within 12 hours I could read newsprint without the aid spectacles. It is now 4 months since the procedure and having undergone 3 equally thorough post operative checks the result continues to improve. I am now free to pursue my passion for wildlife photography and bird watching without the constant annoyance of spectacles hanging around my neck and the only regret is that I didn't have the procedure carried out years ago! If you are in any doubt forget it, make an appointment to see Valerie, put your trust in her abilities and enjoy a life changing experience. Brilliant!

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    Sarah Datson

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    Verity Westcott

  • I was considering having laser eye surgery on my right eye. I consulted Valerie who diagnosed me with keratoconus. Valerie recommended inserting a Keraring in my eye instead of laser treatment. The results are amazing, 20/20 vision achieved. I cannot thank Valerie enough.

    Kevin Carnegie

  • I have always considered having laser eye surgery. After using contact lenses and glasses for over 10 years, I decided to go ahead with it. After going online to look at reviews on Moorfields website Ms V Saw had very good feedback. Having had a consultation which was brilliant and answered all my questions, I then decided to proceed with surgery. Obviously going in for the surgery can seem quite daunting but everyone, especially Miss Saw, put me at ease and told me what was happening throughout the procedure. It has been the best thing I have ever done and would do it all over again! Miss Saw was fantastic. I would recommend her to anyone considering Lasik Surgery. Thank you!

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    Diane McGarva

  • Dr Saw completed my laser eye surgery in November 2016. Her team completed a thorough pre-assessment of my eyes and determined I was suitable for surgery. On the day of the surgery I was walked through the process step-by-step to ensure I was comfortable with what was going to happen, as well as information about how long different things would take.
    I’ve had several follow up appointments and have reached out to Dr Saw multiple times with questions, all of which have been responded to promptly. My vision is now better than 20/20.
    
My wife is also looking to get laser eye surgery and we'll definitely be going back to see Dr Saw!

    Graham R.

  • After years of suffering with dry eyes and several visits to consultants in the Midlands, I was getting extremely frustrated and losing hope of finding anyone who could understand my problem fully and offer me sound advice with a plan for improvement. I had both Meibomian gland dysfunction and aqueous tear deficiency, with occasional secondary inflammation. Since 2002 I had used a variety of drops and also tried punctal plugs, but had developed infections.

    After another search on the Internet and looking at London consultants, I noticed Ms Saw had an amazing CV and had Dry Eye as one of her areas of expertise. My first visit to Valerie in March 2015, instantly gave me the hope I was seeking. She was so understanding, reassuring and kind. Valerie took time to investigate and diagnose my symptoms fully and I came away with a new treatment regime offering various options, as part of a plan for improving my condition in the short and long term. As one of my treatment options, Valerie carried out Cautery of the lower tear ducts and fitting of a punctual plug in one of the upper.

    In 2016 my eyes are now far more comfortable and I am slowly reducing medication. I am using a good combination of drops and ointment and continue with a hot massage routine.
    I have travelled from Staffordshire for all of my visits and will happily continue to do so, Valerie is unique in my view, and so it is well worth the effort to get the best.

    Clearly our rating out of 5 is 6

    Mrs Stephanie James

  • The service provided by Valerie and her team was fantastic and I am very pleased with the results. I would not hesitate to recommend her to any of my friends or family.

    Caolan Gardner

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  • Ms Saw is an outstanding surgeon. Very clear information and individual attention as I had long standing conjunctivitis and blepharitis as well as myopia. Felt fully prepared for the surgery and extremely confident in her skill. Delighted to wholeheartedly recommend both the procedure and Ms Saw. Can’t believe I didn’t have this done years ago!

    Emma Hawkes

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    Jabin Ahmed

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    Matt De Moraes

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    David Pollicott

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    Michael Hart

  • I wish I’d had the treatment years ago. It’s transformed my life, stripping out a whole layer of stress, anxiety and upset. I was terrified of the procedure and the recovery process for PRK. It was over in moments and in retrospect, neither the treatment or recovery felt like a big deal. I can’t recommend Valerie Saw highly enough. She took time to answer my numerous questions in-depth, face-to-face during consultations as well as over the phone and via email. She put me at ease and she has changed my life for the better, and for this I am eternally grateful.

    Alex Smith

  • After 40+ years of glasses/contacts had LASIK about three months ago. Miss Saw and her team were excellent. Friendly, professional and thorough. I understood all aspects of the procedure and could not be happier with the results.

    Mrs N

  • Ms Valerie Saw is a friendly and very professional eye surgeon. She is very thorough during the examination. Valerie immediately put me at ease providing just the right amount of information to enable me to make the right decision about having laser eye surgery (after over 45 years of wearing glasses for astigmatism and myopia the idea was a bit scary!) During the surgery when I was quite nervous Valerie was reassuring, efficient and kept me fully informed. After surgery I received complete care and attention. Valerie made sure I understood exactly what I needed to do to take the best care of my eyes. I now have great vision with no glasses at all, even reading a computer screen all day.

    Chris Stott

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    Yvette Van Leeuwen

  • Having worn glasses since the age of 8, it was difficult to explain the decision to undergo surgery to correct my vision. However, how glad I am that I went through with it. Valerie was amazing, patiently explaining everything and answering questions, even in the run-up to the surgery date. On the day itself, Valerie and her team made the whole experience calm and stress free and it is astounding that such a life changing result can be achieved so easily, and pain/ stress free. I had the surgery in February and have recently returned from an early summer holiday – no glasses, prescription sunglasses, contact lenses, comfort drops etc. Just my new eyes and a pair of sunglasses! I would thoroughly recommend the amazing Valerie and Moorfields hospital.

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    Carla Finlayson

  • What a lovely lady! What a fantastic surgeon. My husband has only had one good eye since birth, and that was getting worse and worse. He had to wear glasses all the time and it makes things like wearing goggles for skiing and workshop tasks difficult. He went to a couple of laser surgeons to find out if he could have something done to this one eye, but, they wouldn't even consider it in case something went wrong. However, we went to see Miss Saw and she didn't see any problems, she only saw solutions. He now has 20/20 vision in that eye and sees better than he has since his 20's. It was easy, friendly and a comfortable experience for both of us. Can't praise her enough. Wonderful, she has changed his life.

    Carole Jones

  • By the end of the first consultation, I felt sure I knew what I was entering into. During the surgery, Ms Saw explained the progress the laser was making, and kept me calm. I would highly recommend having the surgery with Valerie Saw, who is calm in speech and professional in approach, essential qualities when dealing with patients looking to make important decisions on issues as sensitive as their sight.

    Aatish Thakerar

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    Leonardo L.

  • Lens replacement surgery in November 2016.
    Not needing reading glasses is amazing!

    Rick B.

  • When I first thought about getting my eyes done, I refused to go to the regularly advertised companies as I found them too pushy and unsatisfactory when it came to answering my questions. However, when visiting Ms Saw she immediately put me at ease. My concerns over side effects and dry eyes were put to one side once Ms Saw explained very clearly and in detail what the likely outcome would be and how I would be able to look after my dry eyes. Ms Saw advised me to use a hot compress which worked very well in preparation for the procedure and I continue to use this method. It’s now been two years since I've had the operation and I've got to say I've had minimal pain and discomfort. It's now two years on and despite dry eyes and fear of side effects, I could not be happier with the outcome. My vision is fantastic and it feels wonderful to be able to wake up, watch tv, go for a walk or even look at signs on the tube platforms without using my glasses. Ms Saw's care pre and post operation have been exceptional. If you are in any way apprehensive or nervous, I highly recommend Ms Saw. Quite simply you could not be in better hands!

    Ms Dhaliwal

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    Andrea Rees

  • "Calm and clear. I was particularly grateful for being able to contact Valerie both pre and post-surgery with questions. The teams both in Valerie’s practice and at Moorfields were friendly, reassuring and approachable. Thank you for taking such good care of my sight!"

    O. Robinson

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    Andrew Lee

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    TCK

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    Nicholas Pollitt

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    Justin Wilson

  • I am extremely glad I went with Valerie and her team, they were friendly, caring, informative and professional. The surgery was so quick, easy and pain free. I was extremely nervous about the procedure, just the thought made my stomach turn. Valerie and her team made me feel extremely relaxed and explained the procedure clearly to me. The nurses on the day were really helpful and explained all the aftercare drops to me. I still can’t believe I went through with it but so glad I did and would recommend it to anyone and would highly recommend going to Moorfields and having Valerie as your surgeon. Her voice is extremely calming whilst the procedure is taking place.

    Sarah Dean

  • I was so afraid of this operation but Ms Saw has a calm and gentle manner which is so reassuring to the patient. Her skills are outstanding – I can’t remember being able to see from early childhood, but because of Ms Saw’s abilities a miracle has occurred and I can see when I open my eyes. I am so grateful to her.

    Brenda Garnham

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    Mark Glock

  • After being blind as a bat for over 30 years, I finally gave into having laser eye surgery. After researching the issue, I decided on Moorfields as the best option. This has been endorsed by my whole experience from start to finish. Miss Saw and her team were professional, dedicated and supportive through the whole process and I wouldn’t hesitate to recommend them as the way to go if you're thinking of this treatment. Thanks for giving me my sight back!

    Andrew Rowley

  • I could not be happier with my decision to have laser eye surgery to correct short-sightedness/ astigmatism performed by Miss Saw. Miss Saw is professional, calm and reassuring. She talked me through the procedure which took around 10-15 minutes one afternoon. I woke up the next morning and could see without glasses or lenses for the first time in 30 years. A year on I have 20/20 vision, no problems driving at night or otherwise. Brilliant!

    Julie Brownson

  • I highly recommend undertaking laser surgery with Valerie. I had a very high prescription (-8) and was wearing spectacles and then contact lenses since I was 5 years old. I was a bit apprehensive at the start but Valerie was very reassuring from the beginning. I received all the information I wanted allowing me to make my choice. The surgery (in May 2016) didn’t take long at all and the discomfort only lasted a couple of hours. I was provided with a range of drops including anesthetics drops against the pain which were very efficient. After a few hours, I was seeing and my vision settled very quickly after then. I was driving my son to school after 48h. Valerie gave me her mobile number allowing me to call her, anytime (even during the weekend) if I had any concerns. This was really reassuring. She is making herself available for her patients and is very caring. My vision is now perfect, which is an amazing and crazy feeling! Whenever friends mention laser surgery, I encourage them to see Valerie as I know they will be in very safe hands. The clinic facilities at AVC are very clean and modern, as you would expect for private facilities. You are very well looked after all way through.

    Lauren A.

  • I can’t thank Valerie enough for completely transforming my vision: from -8.50 and virtually no vision without glasses or lenses to perfect vision for both distance and reading. At all stages Valerie provided a totally professional service. The aftercare support was fantastic. I cannot think of a more successful outcome nor a surgeon I could more highly recommend.

    Timothy Oliver

  • Having a very high prescription most of my life was restricting in everyday life. I waited until I was ready to take the plunge and have the eye surgery (mainly due to confidence and checking to see what would be suitable for my high prescription). Ms Saw has been very helpful and supportive during the whole procedure and we have both been surprised and happy by the results of the surgery

    Deepkamal Bakhshi

  • Great level of care. I felt that they really cared at all stages through the consultancy all the way to the surgery and then the aftercare. I was able to call anytime if I had a problem. Perfect vision. I would highly recommend it to anyone considering laser eye surgery.

    Taharul Islam

  • Well taken care of. Surgery went very well and aftercare excellent. I have 20/20 vision, the best thing I have ever spent my money on. Would recommend LASIK eye surgery.

    Pasqualina Rasile

  • I had absolutely no idea of what to expect when I discovered cataracts in my eyes. And I was living abroad. On my first visit, during my initial consultation Valerie explained in very simple but concise terms what to expect and was able to put my mind at ease. She also fully outlined what type of resulting vision to expect including all the main side effects. I came back to London 3 months later and we were able to operate on both eyes, and I left London a week later, fully armed with instructions and eye drops. Due to being abroad I called once just to discuss over the phone how I felt my vision was and to ensure that I was on track. Once again even from afar Valerie was spot on with advice and suggestions. Six months on and I have had my follow up visit. My eye-sight is perfect, the side effects are minimal. I would highly recommend Valerie Saw to anyone considering eye surgery; you can be certain of being in good, professional hands with optimum results.

    Bola Awoyinka

  • Very pleased with the results. The novelty has not worn off yet! Ms Saw is very gentle and calm. I would do it all again in a heartbeat.

    Charlotte Leonard

  • I had lens replacement (IOL, RLE) surgery to fix short-sightedness in Feb/Mar 2013. I’ve had my first annual check up everything is fine. I’m extremely happy with the outcome and would happily recommend this surgery to anyone, especially if you have severe short-sightedness. Valerie Saw is not only highly qualified, but helpful, kind, gentle and patient as well and I highly recommend her to anyone considering this type of surgery.

    Louise De Kock

  • After many years debating whether to have surgery I eventually booked an appointment with Ms Saw. Valerie and her team explained everything fully, addressed my worries and put me at ease. The procedure was easier than I thought it would be and I only wish I had done it sooner. Thanks to Ms Saw I do not need glasses anymore.

    Lynda Parker

  • I had spent a lot of time researching LASIK surgery as it was something that I was fearful of having done, even though I really wanted to improve my sight. I could not have chosen a better surgeon than Valerie Saw. Not only did she keep me fully reassured and informed at all time, her manner and personality left me feeling instantly at ease in her care. The treatment itself was not as scary as I had anticipated and either Valerie or her team were always at the other end of the phone if I needed assistance with aftercare. It has been one of the best decisions I have made and I am so pleased that I chose Valerie for my treatment.

    Richard Knight

  • Valerie Saw carried out cataract surgery on me as a private patient in April of 2011 at Moorfields Eye Hospital in London. I am absolutely delighted with the outcome and can't praise her skills enough.

    Kenneth Fish
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