The CMGs offer information on the diagnosis and management of a range of conditions that present with varying frequency in primary and first contact care.
Recurrent corneal erosion syndrome is the result of defective adhesion to the basement membrane. The breakdown of corneal epithelium causes unilateral pain, typically when patients awaken. The condition, which may recur over weeks or months, can wake patients during the night, and cause lacrimation, photophobia and blurred vision. It may be due to previous corneal injury or corneal dystrophy. This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing and treating recurrent corneal epithelial erosion syndrome. It outlines options for non-pharmacological management and pharmacological treatment, and when referral may be appropriate.
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What is recurrent corneal erosion syndrome?
In this condition the surface layer of the cornea (the clear window of the eye) breaks down, causing sharp pain, watering and sometimes blurred vision. These symptoms typically happen as the patient wakes after sleep. The condition may occur after a previous mild injury (corneal abrasion) or may be due to a condition known as a corneal dystrophy in which the surface of the cornea is unusually delicate. The condition may come back over weeks or months.
How is recurrent corneal erosion syndrome managed?
Recurrent corneal erosion is treated by reducing friction between the eye and the eyelids, using lubricating drops and/or ointments, to help the surface of the eye to heal fully. Sometimes other measures are needed, such as a special contact lens applied as a bandage, or referral to an ophthalmologist (specialist eye doctor) for minor surgery or laser therapy..
Recurrent corneal erosion syndrome - 5 November 2026 The predisposing factors section has been updated to include revised prevalence estimates of the various causes of recurrent corneal erosion (RCE); and to highlight that RCE may also be idiopathic. The signs section has been amended to include additional features commonly observed at presentation. The non-pharmacological management section has been amended to clarify that antibiotic cover should be used where bandage contact lenses are used for treating RCE. The pharmacological management section has been updated to include consideration of hypertonic sodium chloride as an alternative therapeutic option. The management category section has also been amended to clearly identify which cases of RCE should be considered for referral.
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