Common Conditions that Affect the Cornea
Dry Eye
Many people experience a sensation of eye dryness, commonly referred to as “dry eye.” Symptoms range from an irritated eye in certain conditions to blurriness, redness, and foreign body sensation. These symptoms may only mildly interfere with one’s life or, in some cases, cause a severe disability. This irritation of the eye’s surface can have many different causes, and we need to determine which ones apply to you. A variety of treatment options are available, the choice of which depends on the severity of the disease and the findings on examination.
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Inflammation and infection of the conjunctiva and cornea:
Inflammation may affect the conjunctiva, a highly specialized membrane that covers the front of the eye. Allergies, reactions to chemicals, or infections may cause it. Viruses, fungi, bacteria, or protozoa may cause infections. If the infection affects the cornea, it may cause a corneal ulcer. Corneal infections are associated with redness, pain, light sensitivity, and reduced vision in the affected eye. Any infection in the cornea can lead to scar formation. Scarring can reduce the quality of vision, so prompt diagnosis and treatment of infections is critical. Risk factors for corneal infections include contact lens wear, injury, or eye trauma.
Fuchs’ Dystrophy
Fuchs’ dystrophy is a non-inflammatory, genetic corneal condition that may be progressive and may affect both eyes. The internal cell lining of the cornea, called the endothelium, becomes damaged. If the endothelium does not function properly, fluid accumulates in the cornea, which causes clouding and a slight decrease in vision. Initially, patients may notice blurred vision in the morning, accompanied by a glare or halos around lights. As the dystrophy progresses, one’s vision can be blurred all day long. Early Fuchs’ dystrophy can be treated with hypertonic saline drops to help remove excess fluid from the cornea. In more advanced cases, partial corneal transplantation (Endothelial Keratoplasty) may be necessary to replace the damaged cells and restore vision. Modern-day endothelial keratoplasty is highly successful, and patients experience a faster recovery compared to previous transplantation methods available.
Corneal transplantation
In patients who have corneal disease affecting the endothelium (the innermost layer of the cornea), partial corneal transplantation can be offered to restore vision. Two types of partial thickness corneal transplants offered are Descemet’s Membrane Endothelial Keratoplasty (DMEK) and Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK). In these procedures, a smaller amount of corneal tissue is transplanted, offering faster visual recovery for patients with corneal swelling caused by endothelial conditions such as Fuchs’ dystrophy and endothelial damage. Only a very thin layer of cornea is removed and then replaced with a thin layer of donor cornea. Patients who undergo partial corneal transplantation also have better visual potential and a lower risk of rejection when compared to full-thickness corneal transplants.
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Keratoconus
Keratoconus is a condition that gradually changes the shape of the cornea, the clear front window of the eye. As the cornea thins and weakens, it can bulge forward into a more cone-like shape, which may cause blurred or distorted vision, increased glare, and frequent prescription changes that glasses cannot fully correct. For some people, the impact is mild, while for others it can significantly interfere with reading, driving, and night vision. Keratoconus can be influenced by several factors, including genetics and chronic eye rubbing, often linked to allergies or eye irritation. Understanding your history matters. The good news is that there are multiple ways to manage keratoconus based on your stage and symptoms, including advanced corneal imaging to monitor progression, specialty contact lenses to improve vision, and corneal collagen cross-linking to help slow or stop progression when appropriate.
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If symptoms of corneal disease are causing you discomfort and affecting your daily life, please call us. Our doctors possess the expertise and tools to provide you with the relief you need.
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