Dry Eyes & Corneal Erosion… Nighttime Ointment? Gel Drops? Scleral Lens!?

Dry eyes – ugh!

In my case, years of eye problems, including two corneal transplants for keratoconus, wedge resections, cataract surgery, and simply getting older (though I hate to admit that!) eventually led to chronic dry eyes.

The most painful result has been recurrent corneal erosion.

Imagine waking up and feeling as though someone scratched your eye with sandpaper. That’s essentially what it feels like. The surface of the cornea doesn’t heal firmly enough from an old corneal scratch. When your eyelid sticks to it overnight, it can pull away some of the corneal tissue when you first open your eye.

Fortunately, my ophthalmologist said the solution in my case was fairly straightforward: keep the surface of the eye well lubricated, especially while sleeping, so the eyelid doesn’t stick to the cornea as it heals.

Here’s what I’ve found works.

Systane Nighttime Ointment

My doctor recommended using Systane Nighttime Ointment every night.

It’s available over the counter and is designed to provide long-lasting lubrication while you sleep.

The upside? My eyes felt noticeably better. Corneal erosion episodes became much less frequent.

The downside? It’s an ointment.

Applying it isn’t difficult, but it is a little messy. You pull down your lower eyelid, squeeze in a small ribbon of ointment, close your eye, and let it spread across the surface.

The tradeoff for that thick protection is blurry vision.

Once it’s in, you’re basically done seeing clearly for the night, so it’s best applied immediately before bed.

And I’d wake up to blurry vision until I rinsed my eyes and blinked everything clear.

It works well, but I really didn’t like waking up with blurry vision. What if something happened and I needed to wake up and see?

Systane Gel Drops

That led me to try Systane Gel Drops.

Alcon describes them as offering “the convenience of a drop with the protection of a gel.”

I’d describe them as somewhere between a drop and a gel. Let’s say gell-light.

They’re noticeably thicker than regular artificial tears, but easier to use than the nighttime ointment.

The drops go in just like standard eye drops. They cause only temporary blurring, making them much more convenient.

In my experience, they’ve provided enough overnight lubrication that I had fewer issues with corneal erosion.

But it didn’t go away completely.

Scleral Contact Lenses: The Biggest Surprise

I resisted these bad boys for years. They’re huge!

They are much larger than regular contact lenses. They looked intimidating.

If you wear regular contact lens, you’ve probably had that nightmare where you are trying to put dinner plate size lens in your eyes and can’t get them in.

Yeh, these will make you think about that!

But darn… okay, they take some practice to get in… but once in, they are super comfortable.

With my eyes, I gave up on contact lens a long time ago – but now I’m back.

Here’s how they work: a scleral lens rests on the white part of the eye (the sclera) and vaults over the cornea without touching it.

Before inserting the lens, you fill it up with sterile saline solution, creating a fluid reservoir that continuously bathes the surface of the cornea.

For me, that fluid-filled cushion provides immediate relief when my eye hurts.

Instead of my eyelid rubbing across an already damaged surface with every blink, the cornea remains protected beneath the reservoir of saline.

I’ve also noticed something else. The relief doesn’t end when I remove the lens.

Because the cornea has spent several hours protected from friction while remaining continuously hydrated, it often has time to heal. My eye is usually much more comfortable afterward, even once the lens is out.

If you have persistent dry eyes, corneal disease, or recurrent corneal erosion, I highly recommend talking to your eye doctor about scleral lens and giving them a chance.