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Have you ever experienced an uncomfortable feeling of sand in your eyes that never seems to go away? A condition called ocular epitheliopathy is often behind this disorder. Understanding the causes, symptoms and risk factors is key to protecting your visual health and preventing possible complications. In this article we will clearly and comprehensively explore everything you need to know about this condition.

What is Ocular Epitheliopathy

Ocular epitheliopathy is a condition that affects the surface of the eye, particularly the corneal epithelium, the outermost layer of the cornea. When this lining becomes altered or damaged, even slightly, the cornea loses its natural protective and lubricating function. The result? A continuous foreign body sensation, as if tiny grains of sand were scratching the eye with every blink.

This condition can manifest itself in a mild or moderate form, but if neglected it can evolve into more complex disorders. Understanding the mechanisms underlying epitheliopathy is the first step towards effective management.

Importance of Early Diagnosis

Early intervention makes all the difference. Early diagnosis can prevent more important damage to the epithelial layer and the cornea itself. If the problem is ignored, the eye becomes more vulnerable to infection, abrasion, ulceration and, in the most severe cases, can lead to impaired vision.

Many people underestimate the symptoms because they initially seem mild. However, recognising alarm bells early on and seeking professional help can prevent complications that are difficult to treat.

Main Causes of Epitheliopathy

Corneal Diseases and Lacrimal Alterations

One of the main causes of epitheliopathy is diseases affecting the cornea.

Corneal dystrophies, for example, change the structure and resistance of the epithelium, making it more susceptible to trauma. Disturbances of the tear film also play a crucial role: an alteration in the quality or quantity of tears leads to dryness, irritation and superficial micro-injuries.

Sjögren's syndrome is a particularly relevant example. It affects the lacrimal and salivary glands, drastically reducing tear production. Approximately 20% of patients with this disease develop more or less severe forms of epitheliopathy, with persistent symptoms that are difficult to ignore.

Improper Use of Contact Lenses

Contact lenses are comfortable, but can become a risk if used incorrectly. Prolonged use, poor hygiene, unsuitable materials or individual sensitivity can lead to microtrauma of the epithelium. A poorly oxygenated cornea weakens, loses elasticity and becomes more fragile.

It is essential to follow the guidelines provided by the optician or ophthalmologist:

• respect the time of use,
• do not sleep with lenses,
• clean them properly,
• replace them when necessary.

Common Symptoms to Recognise

Pain and Foreign Body Sensation

The feeling of having something in the eye is one of the most frequent signs of epithelioma. Sometimes the discomfort is mild, other times it becomes so insistent that it disturbs daily activities. The pain may increase during blinking, when the injured epithelium is stressed by the movement of the eyelids.

This sensation should never be underestimated: it is a clear indication that the ocular surface is not intact and needs specialist attention.

Vulnerability to Ocular Infections

A damaged ocular surface functions as a semi-open door to infection. When the epithelium loses its protective function, bacteria and viruses find fertile ground to colonise the area. Redness, discharge, throbbing pain and photophobia are alarm bells that require immediate control.

Early intervention can prevent progression to more serious conditions, such as infectious keratitis.

Risk Factors to Consider

Sjögren's syndrome and autoimmune diseases

Sjögren's syndrome is one of the best known risk factors. More than 75% of patients experience severe dry eye, which over time compromises the corneal epithelium.

Other autoimmune diseases, such as rheumatoid arthritis, lupus or thyroiditis, can also negatively affect the health of the ocular surface. Systemic inflammation reduces the stability of the tear film and alters epithelial regeneration.

Implications of High Myopia

High myopia not only affects the quality of vision: it also affects the structure of the eye. In some cases, anatomical changes make the epithelium thinner and more sensitive to microtrauma. People with high myopia should have regular check-ups to monitor both the retina and the health of the ocular surface, which is often neglected.

Related Pathologies and Necessary Interventions

If left untreated, epitheliopathy can develop into more serious forms, such as recurrent epithelial detachment, a painful condition in which the epithelium lifts off the cornea. This phenomenon makes the eye extremely sensitive to any movement and often requires dedicated treatment.

Depending on the severity, the doctor may propose:

• specific ocular lubricants
• autologous sera
• therapeutic contact lenses
• laser treatments
• targeted surgery

The 80% of patients who receive an early diagnosis can effectively manage the condition and prevent complications.

Role of the Ocular Health Professional

A good specialist makes all the difference. The ophthalmologist not only assesses the situation, but also constructs a customised treatment path. Regular monitoring of ocular health makes it possible to intervene immediately in the case of even the slightest changes in epithelial status.

Prevention involves regular check-ups, especially for those who wear contact lenses, suffer from dryness or have already had episodes of epitheliopathy.