Corneal Diseases, Disorders and Treatments
There are many diseases that can affect the cornea, causing pain or loss of vision. Disease, infection or injury can cause the cornea to swell (edema) or degrade (become cloudy and reduce vision). Common diseases and disorders include:
- Keratitis (Viral Inflammation)
- Ocular Herpes
- Shingles (Herpes Zoster)
- Recurrent Erosion Syndrome (RCE)
Dry eye occurs when the eyes are not sufficiently moisturized, leading to itching, redness and pain from dry spots on the surface of the eye. People usually begin experiencing dry eye symptoms as they age, but the condition can also result from certain medications, conditions or injuries.
Dry eye is not only painful, but can also damage the eye's tissues and impair vision. Non-surgical treatments for dry eye include increasing humidity at home or work and use of artificial tears or moisturizing ointment. If these methods fail, small punctal plugs may be inserted in the corners of the eyes to limit tear drainage.
What is a Corneal Dystrophy?
Generally speaking a corneal dystrophy is a non-infectious, non-inflammatory gradual deterioration of one of the five layers of the cornea. Some dystrophies are believed to be hereditary, are usually bilateral, and can be progressive. There are a variety of corneal dystrophies but the two most common are Epithelial Basement Membrane Dystrophy (EBMD) and Map-Dot-Fingerprint Dystrophy (MDD).
Epithelial Basement Membrane Dystrophy (EBMD)
Also known as Map-Dot-Fingerprint Dystrophy (MDD), a disease or anatomical defect of the cornea which affects the ability of the epithelium (outer "skin" of the cornea) to attach to the lower layers of the cornea. Instead, it grows unevenly or detaches.
Fuchs' dystrophy is an inherited eye disease that causes the cells in the last layer of the cornea to deteriorate, leading to distorted vision and corneal swelling. The exact cause of Fuchs' dystrophy is unknown, but is believed to be a combination of hereditary, hormonal and inflammatory factors. This condition affects both eyes and is more common in women than in men. Symptoms do not usually appear until the patient is over the age of 50.
While there is no cure for Fuchs' dystrophy, there are several treatment options available to help relieve symptoms and prevent permanent damage. In its early stages, Fuchs' dystrophy can often be treated with a salt solution to remove fluid from the eye and reduce swelling. In more advanced stages patients may require a corneal transplant.
Keratoconus is a progressive eye disease in which the normally round cornea thins and begins to bulge into a cone-like shape. The cornea is the clear, central part of the surface of the eye. In patients with keratoconus, the cone-shaped cornea deflects light and causes distorted vision. Changes in the shape of the cornea occur gradually, usually over several years.
Early stages of keratoconus can be treated with eyeglasses or soft contact lenses, while progressive keratoconus treatment may include rigid gas-permeable contact lenses. If keratoconus persists, corneal transplant surgery can be performed to correct the condition.
Phototherapeutic Keratectomy (PTK)
Phototherapeutic Keratectomy is an advanced laser procedure used to treat corneal abnormalities such as scar tissue or an irregular surface that causes blurry vision or discomfort within the eye. PTK is ideal for corneal conditions such as:
- Epithelial erosion syndrome (RCE)
- Corneal scars
- Epithelial basement membrane dystrophy (EBMD) and Map-dot-fingerprint dystrophy (MDD)
Corneal Transplant - DSAEK
The cornea is the clear covering of the front of the eye which bends, or refracts, light rays as they enter the eye. The cornea must have the correct shape and clarity to focus incoming light rays precisely on the retina at the back of the eye. When the cornea becomes cloudy or misshapen from injury, infection or disease, transplantation may be recommended to replace it.
Short for Descemet's stripping and automated endothelial keratoplasty, DSAEK replaces only the damaged, innermost layers of cells within the cornea, known as the endothelium, while leaving the healthy parts intact. This allows the procedure to be performed through a much smaller incision with shorter recovery times and fewer risks than a traditional corneal transplant.
To learn more about our Cornea Services, please contact us today to schedule an appointment.