Especially during rust ring removal with the Algerbrush, it is not only the foreign matter that is being removed, it is also the stained corneal epithelium that the brush takes off. The clinician must inform the patient about the course of the treatment and the fact that additional discomfort is likely given the procedure performed on a highly sensitive tissue. It is best, however, to wait and not remove the rust ring until a few days have elapsed. When this happens, removal of the complex becomes a relatively easy matter. Pursuing removal too early may cause unnecessarily large abrasion for extraction of relatively small amounts of foreign matter.
Recurrent erosion is a term applied to sloughing off of the epithelial cells after an injury.
It typically occurs while the eye is closed. The patient generally experiences mild to severe discomfort in the middle of the night or upon awakening in the morning. This is obviously because of relative hypoxia which takes place when the eyes are closed. To reduce the chance of recurrent erosion particularly following larger and deeper abrasions, hypertonic therapy is indicated. It is best to wait till corneal healing has occurred so that the discomfort upon instillation is minimized.