Cornea Conditions

The cornea is the clear, front part of the eye that covers the front of the eye. The cornea serves as a protection from dirt or germs that can damage the eye. The cornea plays a crucial role in vision. As light enters the eye, it is refracted by the outside of the cornea. The curvature of this later determines how well your eye will focus on objects and varying distances.

Common Corneal Conditions

cornea
  • Corneal Abrasions
  • Corneal Ulcers
  • Keratoconus
  • Fuchs’ Dystrophy
  • Pterygium
  • Conjunctivitis
  • Allergies

Corneal Abrasions

Abrasions of the cornea result from scratching or cutting the thin later of skin of the cornea. This can cause pain, a gritty feeling, tearing or a foreign body sensation. Blinking and rubbing can irritate the condition. Most corneal abrasions will heal in 24 to 72 hours on their own, however if you are experiencing discomfort, Dr. Adelson can prescribe some anti-inflammatory drops. If the abrasion is not healing or you can see an object in the eye that cannot be removed, you will need to come in for removal before the healing process can begin.

Corneal Ulcers

When an open sore on the cornea occurs, this is called a corneal ulcer. Ulcers can result from various eye infections, abrasions or burns to the cornea or severe dry eye.

Symptoms
  • Blurred vision
  • Swelling of the eyelid
  • Redness
  • Feeling of having something in the eye
  • Tearing
  • White spot on the cornea that you may see when looking in the mirror
  • Pain in the eye
Diagnosing

Dr. Adelson will inject a dye called fluorescein to illuminate your cornea to check damage to the cornea and to determine if you have a cornea ulcer.

Treatment
  • Blurred vision
  • Medication – antibiotics, antifungals or antivirals or steroid anti-inflammatory drops
  • Surgical treatment – if the ulcer cannot be treated with medication, surgery may be needed.

Keratoconus

Keratoconus,is a relatively uncommon eye disease that causes the cornea to become become thin and develop a cone-like appearance. Once the shape of the cornea is altered, your vision will become distorted. Keratoconus typically affects both eyes and begins at a younger age – usually as a teenager.

Symptoms
  • blurred vision
  • distorted vision
  • sensitivity to light
  • frequent prescription changes
Diagnosing

A complete eye exam will be performed. The slit lamp will be used to diagnose keratoconus. Dr. Adelson may need to perform a reflection test to determine the curve of the cornea or a procedure that involves mapping the cornea with a series of pictures.

Treatment
  • Gas permeable contact lenses – the usual treatment for keratoconus – used to counteract the distortion of the cornea,. Lenses are custom made and a custom fitting is required to ensure vision is optimal and comfortable.
  • Surgery – severe cases will require surgical options but it’s highly unlikely unless there is significant scarring of the cornea. At that point, a corneal transplant surgery will be recommended where the scarred tissue is replaced with a section of clear and healthy corneal tissue.
  • Intacs – are a small curved implatable device that helps reshape the cornea. This procedure is recommended for patients who cannot wear GP lenses and whose disease is not in need of a corneal transplant.

Patients with keratoconus may not have LASIK surgery or other laser vision correction surgeries.

Fuchs’ Dystrophy

Fuchs’ dystrophy is a slow progressing disease that occurs when the cells on the cornea gradually deteriorate without a reason. Fuchs’ dystrophy normally affects both eyes and is more common in women than men. Hereditary is usually the cause.

Symptoms
  • Blurred vision, worse in the morning – first symptom present
  • Fluctuating eyesight – gets better and worse throughout the day
  • Halos around lights – light sensitivity
  • Sandy, gritty sensation
  • Discomfort in bright light – sometimes sharp, incapacitating pain
Diagnosing

The dystrophy typically does not affect vision until patients are older – in their 50’s and 60’s. Dr. Adelson can detect the disease using a slit lamp hat magnifies the cells of the cornea. He then uses a pachymetry that measures the thickness of the cornea.

Treatment

Fuchs’ dystrophy cannot be cured but there are options to treat the condition and prevent it from worsening,

  • Medications – Steroid eye drops or ointments can reduce the amount of fluid in the cornea.
  • Dry the eyes – using a hair dryer at arm’s length and blow the warm air across your face a few times. This helps increases evaporation of water from the cornea.
  • Try soft contact lenses – can improve vision and reduce discomfort,
  • Corneal transplant surgery – can replace damaged corneal tissue and replace with healthy tissue.
Fuchs’ Dystrophy and Cataracts

When a cataract develops in a patient with Fuchs’ dystrophy, it is important to have Dr. Adelson evaluate the tissue to determine is the cornea can function post cataract surgery. Some patients undergo a cataract surgery along with a corneal transplant to achieve optimal results and have a shorter healing process.

Pterygium

When growths on the cornea and thin white part of eye occur, they are called pterygium. These are common and non cancerous. They typically present as a triangular shaped growth of flesh colored tissue on the white of the eye. They can become red and swollen or larger and thicker. If they get large enough, it will lead to astigmatism.

Symptoms
  • flesh growth on the white of eye
  • blurred vision
  • burning or itching
  • feeling of having something it the eye.
Treatment
  • Medications – lubricating drops or ointments help to reduce inflammation
  • Surgery – if they become large enough or cause discomfort, they can be removed through an outpatient procedure.

Conjunctivitis

Also known as pink eye is the swelling of the conjuctiva of the eye causing tiny blood vessels to form and produce mucus to moisten the eye. See Conjunctivitis (hyperlink to conjunctivitis) for complete symptoms, causes and treatments.

Allergies

Common condition that occurs when the eyes react to something that is an irritant or allergen. The eyes produce a histamine to fight off the allergen which causes the conjunctiva and eyelids to become red and irritated with burning and tearing. This is not contagious.

Symptoms
  • Red or itchy eyes
  • burning
  • tearing
  • light sensitivity
Treatment

The treatment for eye allergies is to identify the allergen and avoid contact. An allergist can help to identify the cause if it’s unknown.

Medications

  • artificial tears – help to relieve symptoms
  • decongestants – over the counter medication to reduce redness
  • antihistamines – helps with itch but can dry the eye and worsen condition tearing

If you are experiencing any corneal conditions, give us a call at 866-340-EYES to schedule an appointment so we can determine the best course of action for treatment.