Understanding Corneal Conditions
The cornea is the clear, dome-shaped front surface of the eye that covers the iris, pupil, and anterior chamber. It acts as a protective layer, shielding the delicate internal structures of the eye from damage. The cornea also plays a significant role in focusing incoming light onto the retina, contributing to clear vision.
Common Corneal Conditions
There are several corneal conditions that can affect the clarity and function of the cornea, leading to vision problems. Some of the most common corneal conditions include:
- Corneal Injuries: The corneal surface may be slightly damaged by a scratch or abrasion or more severely damaged if an ulcer forms. Both corneal abrasions and ulcers will cause pain, redness, and blurred vision but the symptoms are more intense when the cornea ulcerates and there is a higher risk for potential vision loss if left untreated.
- Keratoconus: Keratoconus is a progressive condition in which the cornea thins and bulges into a cone-like shape. It can lead to distorted vision and increased sensitivity to light.
- Corneal Dystrophies: Corneal dystrophies are a group of inherited conditions that affect the cornea’s clarity and structure. Examples include Fuchs’ endothelial dystrophy and corneal map-dot-fingerprint dystrophy.
Corneal Injuries
Corneal injuries could be caused by any of the following:
- Foreign Bodies: People who present with corneal injuries caused by foreign bodies know how, when and where the injury happened. They are usually painful, and people will want to treat these as soon as possible and they are an eye emergency.
- Contact lens wear: Improper cleaning or extended wear of contact lenses increases the risk of corneal damage. See more about contact lens care.
- Bacterial, viral, or fungal infections: These infections can occur due to poor hygiene, contact lens misuse, or exposure to environmental factors such as contaminated water.
- Dry eye syndrome: Insufficient tear production can lead to dryness and damage to the cornea. We offer dry eye treatments.
- Underlying health conditions: Certain conditions, such as autoimmune diseases or vitamin A deficiency, weaken the immune system and make the cornea more vulnerable to infections.
Treatment Options
- Consult your Optometrist or Ophthalmologist: You should consult an Optometrist or Ophthalmologist in cases of eye injuries, infections or dry eyes.
- Aim of Treatment: The key to treating these corneal injuries is to remove any foreign bodies in the eye and then to maintain an infection free environment to allow for rapid repair.
- Regular flushing of the eyes: with sterile saline
- Use of antibiotic, antiviral or antifungal drops: will help to maintain a sterile environment in your eyes – our optometrist can prescribe the most appropriate drops following eye examination.
- Contact lens wear should be immediately discontinued.
- Pain management: Eye drops or ointments may be recommended to alleviate discomfort and promote healing.
- Patch or bandage contact lens: This can protect the cornea, promote healing, and provide relief.
- Close monitoring and follow-up: Regular check-ups with your eye care professional are crucial to monitor the healing process and adjust the treatment plan if necessary.
- Dry eyes: could have multiple causes, see our link for dry eye information.
Shallow and sterile injuries could repair in one or two days. Deeper injuries or injuries which become badly infected could require surgery and may take months to heal.
It is important to note that self-diagnosis and self-treatment for corneal injuries is not recommended. If you suspect you have a corneal injury or are experiencing any symptoms such as eye pain, redness, blurred vision, or light sensitivity, seek immediate medical attention from an eye care professional.
To learn more about other eye conditions and their management, visit our article on eye disease management
Keratoconus
Keratoconus is a progressive eye condition that affects the shape and structure of the cornea. It is characterised by the thinning and bulging of the central cornea into a cone-like shape, which can result in distorted vision.
Causes and Symptoms
The exact cause of keratoconus is not fully understood, but it is believed to involve a combination of genetic, environmental, and biochemical factors. Some studies suggest that chronic eye rubbing, certain hormonal imbalances, and an imbalance of enzymes within the cornea may contribute to the development of keratoconus.
Keratoconus usually starts during adolescence or early adulthood and progresses gradually over time. Common symptoms include:
- Blurred or distorted vision: As the cornea becomes more irregular in shape, it causes blurred or distorted vision, making it difficult to focus on objects.
- Increased sensitivity to light: Individuals with keratoconus may experience increased sensitivity to light, known as photophobia, which can cause discomfort in bright environments.
- Frequent changes in spectacle prescription: Due to the progressive nature of keratoconus, individuals may require frequent changes in their eyeglass prescription to maintain clear vision.
- Halos and ghosting: Many people with keratoconus experience halos and ghosting around lights, especially at night, which can further affect visual clarity.
If you are experiencing any of these symptoms, it is important to consult with an eye care professional for a thorough examination. They can provide an accurate diagnosis and recommend appropriate treatment options.
Treatment Options
While there is no cure for keratoconus, several treatment options are available to manage the condition and improve visual acuity. The choice of treatment depends on the severity of keratoconus and individual needs. Common treatment options include:
- Glasses or contact lenses: In the early stages of keratoconus, glasses or specialized contact lenses, such as rigid gas permeable (RGP) lenses or scleral lenses, can help correct vision by providing a smooth surface for light to pass through the cornea. Regular follow-up appointments with an Optometrist or Ophthalmologist are necessary to monitor any changes in the condition.
- Corneal cross-linking (CXL): Corneal cross-linking is a minimally invasive procedure that aims to strengthen the cornea and slow down the progression of keratoconus. During the procedure, a photosensitizing solution is applied to the cornea, followed by exposure to ultraviolet light. This process helps to create new cross-links between collagen fibres, increasing corneal stability. Corneal cross-linking is often combined with the use of specialised contact lenses for optimal visual correction.
- Intacs or corneal inserts: Intacs are small, thin, semi-circular devices that are surgically inserted into the cornea to reshape its curvature. By flattening the cone-like shape of the cornea, Intacs can improve visual acuity and reduce the need for glasses or contact lenses. This procedure is typically recommended for individuals who are unable to achieve satisfactory vision with glasses or contact lenses alone.
- Corneal transplant: In severe cases of keratoconus where other treatment options are no longer effective, a corneal transplant may be necessary. During a corneal transplant, the damaged cornea is replaced with a healthy donor cornea. This surgical procedure is typically reserved for individuals with advanced keratoconus or those who develop significant corneal scarring.
It is important to consult with an eye care professional to determine the most appropriate treatment option for your specific case of keratoconus. Regular follow-up appointments are crucial to monitor the progression of the condition and ensure optimal visual outcomes.
Understanding the causes and symptoms of keratoconus, as well as the available treatment options, can help individuals with this condition make informed decisions.
Corneal Dystrophies
Corneal dystrophies are a group of inherited eye disorders that affect the cornea, the clear front surface of the eye. They can cause changes in the cornea’s structure and lead to vision problems. Two common types of corneal dystrophies are Fuchs’ Endothelial Dystrophy and Corneal Map-dot-fingerprint Dystrophy.
Fuchs’ Endothelial Dystrophy
Fuchs’ Endothelial Dystrophy primarily affects the corneal endothelium, the innermost layer of cells that help maintain the cornea’s clarity. In this condition, the endothelial cells gradually deteriorate over time, leading to corneal swelling and blurred vision.
Symptoms of Fuchs’ Endothelial Dystrophy may include cloudy or hazy vision in the morning, which improves throughout the day, and increased sensitivity to light. As the disease progresses, vision may become progressively worse.
Treatment Options
Treatment options for Fuchs’ Endothelial Dystrophy depend on the severity of the condition.
- Hypertonic saline drops: may be used in the early stages to reduce corneal swelling and improve vision.
- Descemet’s Stripping Endothelial Keratoplasty (DSEK) or Descemet’s Membrane Endothelial Keratoplasty (DMEK): may be recommended. In advanced cases. These procedures involve replacing the damaged corneal endothelium with healthy donor tissue.
Corneal Map-dot-fingerprint Dystrophy
Corneal Map-dot-fingerprint Dystrophy, also known as Epithelial Basement Membrane Dystrophy, is a condition that affects the outermost layer of the cornea, called the epithelium. It is characterized by irregularities on the corneal surface, which can cause discomfort and visual disturbances.
The name “Map-dot-fingerprint” refers to the appearance of the cornea under a microscope, where irregularly shaped patterns resembling maps, dots, and fingerprints can be observed.
While some individuals with Corneal Map-dot-fingerprint Dystrophy may not experience any symptoms, others may experience recurrent corneal erosions, which can cause sudden eye pain, light sensitivity, and blurred vision.
Treatment Options
Treatment options for Corneal Map-dot-fingerprint Dystrophy primarily focus on managing symptoms and preventing corneal erosions.
- Lubricating eye drops or ointments: may be prescribed to alleviate discomfort and promote healing.
- Bandage Contact Lenses: can be used to protect the corneal surface, particularly from blinking, and allow it to heal faster.
- Epithelial debridement: may be performed to remove the irregular corneal epithelium and encourage the growth of a smoother layer.
By understanding these common corneal dystrophies, individuals can be aware of the symptoms and seek appropriate treatment from an eye care professional.
Regular eye examinations are essential for early detection and management of corneal dystrophies to preserve vision and enhance the quality of life.
If you have questions about your eye health, book an appointment so we can thoroughly check your eyes and answer and questions.
This article is intended to promote understanding of and knowledge about general eye health topics.
It should not be used as a substitute for professional advice, diagnosis or treatment.
Always seek the advice of your health care professional prior to incorporating this as part of your health regimen.
Dr Nicholas Altuneg
For over two decades, my greatest passion has been helping people of all ages live improved lives through better vision. At Eyes by Design, vision is so much more than being able to see clearly or read small letters from far away; it determines your perceptions and reactions every second of the day.
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