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Harvard Medical School
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General Medical Questions
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Question : I have been diagnosed with recurrent corneal erosion.
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The Trusted Source
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Howard LeWine, M.D.

Robert H. Shmerling, M.D. is associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School. He has been a practicing rheumatologist for over 20 years at Beth Israel Deaconess Medical Center. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program.

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August 10, 2012
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A:

Placing “punctal plugs” has become a common procedure for patients with severe dryness of the eyes. These plugs block your tears from draining. So the tears you make last longer in the eye. Your condition sounds severe enough that this approach seems appropriate to consider.

The dryness could be an isolated problem or part of Sjögren’s syndrome (see below). Whatever it’s from, punctal plugs can help relieve symptoms and protect the cornea.

Other ways to help avoid dry eye include:

  • Using artificial tears frequently
  • Steering clear of low-humidity environments
  • If possible, avoiding medicine that makes dryness worse (such as diuretics, antihistamines and certain antidepressants)

There are a variety of eye drops that may reduce irritation and help prevent corneal damage from not making enough tears. Doctors commonly recommend artificial tears and cyclosporine (RESTASIS). Your ophthalmologist can determine the best care for your eyes after a full evaluation.

Sjögren’s syndrome is an autoimmune disease. That’s a condition in which the immune system mistakenly attacks its host. People with Sjögren’s syndrome have dry eyes and mouth and inflammation in multiple organs, including the eyes, joints and skin.

Antibody tests can help diagnose this condition. Diagnosis is important because you may need more than just eye drops. For example, drugs that stimulate saliva production or drugs that suppress the immune system may be helpful. Dry mouth increases the risk of cavities. So your dentist may recommend frequent dental cleaning and an oral rinse with fluoride.

Based on the symptoms you describe, I would suggest you see an ophthalmologist, dentist and rheumatologist for evaluation.

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