Corneal Disorders

Cornea

CORNEAL ABRASION Corneal abrasions, a cut or scratch of the clear window of the eye, are associated with light sensitivity, pain, and tearing. Corneal abrasions may cause mild discomfort or severe pain, depending on the size of the abrasion. Treatment may include lubrication, bandage contact lens, eye patching and/or preventative antibiotic ointment. The cornea is the fastest healing tissue in the human body, thus, most corneal abrasions will heal within 24-36 hours.

BAND KERATOPATHY Band keratopathy is a calcium deposit at the 3-9 o’clock positions in the front layer of the cornea. This deposit of calcium may spread across the cornea in band like appearance. The condition is caused by inflammations, trauma, chronic ocular disease, or even systemic diseases.

Treatment is necessary when the deposits affect vision. If the band of calcium deposits affect visions, chemical removal can be considered. Usually, vision improves following the removal of calcium from the cornea.

CORNEAL DELLEN Dellen are localized areas of thinning, or drying, of the peripheral cornea. Dellen are usually located adjacent to an area of tissue swelling, tissue growth, inflammation, or eyelid abnormality. These abnormalities may alter the eye’s normal ability to spread the tear layer uniformly over the cornea.

Initial treatment involves the use of eye lubrication with artificial tears, and/or ointments. Occasionally bandage contact lenses are used to protect the cornea and promote healing.

CORNEAL ENDOTHELIAL DYSTROPHY Corneal endothelial dystrophies are disorders involving the layer of the cornea closest to the inside of the eye. This condition may result in thickening, cloudiness of the cornea with resultant decreased vision over time. Glare and blurred vision are common upon awakening. The condition, which is usually hereditary usually develops after age 50. Many patients are comforted by the gentle use of a warm hair dryer for 5-10 minutes to dry the cornea. Salt solutions like Muro 128 are helpful. Treatment decreases symptoms, but does not effect the disease.

CORNEAL EPITHELIAL DYSTROPHY Corneal epithelial dystrophies are disorders involve the front surface of the cornea which result in decreased vision due to cloudiness, and surface irregularities of the cornea. If the corneal lesions loose their outer surface layer, like any other wound, they become very painful. These lesions or erosions may become recurrent. Half of the corneal epithelial dystrophies are hereditary in nature.

CORNEAL STROMAL DYSTROPHY Corneal stromal dystrophies are disorders of the middle layer of the cornea. Corneal dystrophies are inherited conditions diseases which may cause symptoms such as glare and/or cloudy vision. Some are only be visible under the microscope and may never affect your vision. Others result in intense glare with diminishing visual acuity.In these cases, a cornea transplant may be necessary to restore useful vision.

RECURRENT CORNEAL EROSIONS Recurrent corneal erosions are a disruption of the front surface of the cornea, which recurs in the same area of the cornea. The normal history is one in which the patient initially had a cut or abrasion to the cornea, which healed normally. Some time later the patient wakes up in the middle of the night with intense pain, blurred vision, and a water eye. Fortunately, the cornea heals rapidly, within 24 hours the cornea has re-surfaced the eroded area. For some unknown reason, when the cornea heals the new tissue does not properly glue down to the underlying surface. The episodes may occur as frequently as weekly or as rarely as years later.

The diagnosis of recurrent corneal erosion is often made by history only. Treatment may range from initial patching and use of medicated drops or ointments, to Laser procedures to aid tissue attachment and stability.

CORNEAL NEOVASCULARIZATION (neo’-vas-cu-Lar-ize-a-tion) corneal neovascularization describes new growth of, undesired blood vessels into the normally clear cornea. These blood vessels are a response to lack of oxygen or significant inflammation of the cornea. When such vascularization of the cornea is observed, it is important to attempt to diminish and hopefully stop this vascular growth. A common cause of neovascularization is over-wear or sleeping with contact lenses. When left uncontrolled, progressive corneal neovascularization may lead to diminished or lost vision.

CORNEAL SCAR The transparency of the cornea can be damaged by disease or by injury to a degree which affects vision. A scar may develop from injury. If the scar is in the middle of the cornea it may affect vision alternatively, if there is scarring in the peripheral area vision will not be affected. If the vision loss due to corneal scarring significantly reduces vision either LASIK or a corneal transplant can restore sight.

CORNEAL ULCER A corneal ulcer is an area of tissue loss from the surface of the cornea. Corneal ulcers may result from bacterial, fungal, or viral infection of the corneal tissue or loss of innervations of the pain nerves to the cornea. All corneal ulcers are serious, sight-threatening lesions that require immediate, aggressive treatment and management. Eye pain, light sensitivity, decreased vision and tearing are common symptoms of these lesions. Treatment is dependent on the cause of inflammation Frequent examination will be necessary until the ulcer has completely resolved.

CORNEAL FOREIGN BODY Corneal foreign body is material that has become embedded in the front part of the eye. Symptoms vary greatly depend on severity; usually producing pain, light sensitivity and tearing. All foreign bodies, especially dirt, metal or glass must be removed for proper healing to occur. After removal, treatment may include any or all of the following: antibiotic drops or ointment, therapeutic contact lens, eye patching and dilation drops. Return visits are necessary until complete healing has occurred.

FUCH’S DYSTROPHY Fuch’s Dystrophy is a degeneration of tissue of the most inner layer of the cornea. This corneal degeneration b