Trigger Factors in Recurrent Corneal Erosion Syndrome

Background/Objectives: Recurrent corneal erosion syndrome (RCES) is a chronic, recurrent, and painful disorder characterized by repeated episodes of sudden ocular pain due to abnormalities in the corneal epithelium or basement membrane (BM). The aim of this study was to investigate the triggering factors in patients with recurrent corneal erosion syndrome. Methods: Medical charts of patients diagnosed with recurrent corneal erosion syndrome among those who visited the outpatient department of Kangnam Sacred Heart Hospital between 2013 and 2017 were investigated. The trigger factors and the patient's ocular symptoms were surveyed, and the severity of symptoms was investigated using a questionnaire. Anterior segment photos and anterior segment optical coherence tomography (AS-OCT) scans were performed. Results: The study included a total of 40 patients, with an average age of 46.18 (±13.81) years. Of these, 17 were men and 23 were women. Twelve patients (30%) had a history of trauma. Twelve (30%) drank alcohol the day before the onset of the disease, thirteen (32.5%) had severe fatigue, eight (20%) smoked and two (5%) exercised heavily. The severity of symptoms is related to age and fatigue. AS-OCT was performed in 18 patients; 94.4% had corneal anterior stromal hyperreflectivity, 61.1% had epithelial edema, 50.0% had irregular epithelial break-up, 44.4% had intraepithelial inclusion cysts, 33.3% had intraepithelial BM, and 11.1% had undetectable epithelial BM. Blurred vision and decreased visual acuity are associated with the absence of epithelial BM. Other AS-OCT findings showed no statistically significant difference from the visual symptoms. Conclusions: The most common triggering factors were fatigue and alcohol drinking. The AS-OCT findings may reflect the pathogenesis and progression of RCES.