Natural history of recurrent erosion syndrome - a 4 year review of 117 patients

Aims/background-Recurrent erosion syndrome encompasses a group of mixed aetiologies for which there are a number of methods of management which may influence the course of the disease. Methods-The outcomes of a cohort of patients initially treated with topical lubricants Were studied. 117 consecutive patients presenting over 1 year with a history of recurrent erosions were enrolled, baseline characteristics were documented, and treatment with lubricants was initiated. Patients were surveyed 4 years later inquiring about symptoms and treatments required. Results-A total of 94 (80%) of the initial cohort were contacted. The mean age was 44 years and the sex distribution was 44 males to 50 females. The mean period of follow up was 48 months. 55 (59%) were Still symptomatic with attacks occurring at a median frequency of 60 days. 13 patients (24%) complained of an episode at least every week and 28 patients (51%,) suffered at least every month. The median pain score (analogue scale of 1-10) was 2.5. Seventy five per cent (n=21) of patients with epithelial basement membrane dystrophy (EBMD) were symptomatic compared with those with a traumatic aetiology among whom 46% (n=28) were symptomatic, This difference was significant (p=0.02). Those with EBMD were more likely to be continuing to use topical lubricants than the trauma group. Conclusion-Patients with a traumatic aetiology are less likely to suffer chronic recurrent erosion syndrome than those with EBMD.