• Cornea
• Treatment Surgery
• Pathology

A long time ago, in 1872, the first description of recurrent corneal erosion syndrome (RCES), termed by the author as ‘intermittent neuralgic vesicular keratitis’, appeared in the ophthalmological literature.1 This painful condition, originally associated with previous trauma, was then also related to corneal epithelial and Bowman's Layer irregularities found in some affected patients.2 In 1944 Chandler defined this syndrome as ‘one of the most remarkable disorders of the eye’,3 and despite the remarkable clinical and surgical advances occurring in ophthalmology in these years, it is still considered a great challenge by ophthalmologists.

RCES can negatively affect the patient's quality of life, causing acute episodes of ocular pain, discomfort, burning, stinging, tearing and redness upon awakening, lasting hours or days. Usually this is a chronic condition characterised by remissions and relapses, with intervals between recurrences from a few weeks to months.

The age at presentation varies from 20 to 80 years old, but the highest prevalence is between the third and fourth decade.4 Patients who present to an ophthalmologist for this condition are usually young, with an active life, who are often worried and anxious about their ocular discomfort. RCES may also affect their ability to work.

RCES clinical signs can vary from punctuate epithelial erosions (microforms) to frank epithelial defects or large areas of loose epithelium (macroforms)3 that may cause acute visual disturbance, photophobia and significant pain, leading to frequent emergency room referral.

Concerning the complex pathogenesis of RCES, which is characterised by a …