Corneal Disease Treatment
The cornea is a thin, clear, spherical layer of tissue on the surface of the eye that provides a window for light to pass through. In a healthy eye, the cornea bends or refracts light rays so they focus precisely on the retina in the back of the eye.
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 (called “edema”) or degrade (become cloudy and reduce vision). Common diseases and disorders that affect the cornea include:
- Allergies
- Bullous Keratopathy
- Conjunctivitis (“Pink Eye”)
- Dry Eye
- Corneal Dystrophies including Fuchs’ Dystrophy and Lattice Dystrophy
- Glaucoma (High Eye Pressure)
- Infections
- Keratitis (Viral Inflammation)
- Keratoconus
- Ocular Herpes
- Pterygium
- Shingles (Herpes Zoster)
- Stevens-Johnson Syndrome
Treatment for corneal disease can take many forms, depending on the underlying problem as well as the patient’s preferences. Some conditions resolve on their own and many can be treated with medication. If the cornea is severely damaged or if there is a risk of blindness, a corneal transplant may be recommended to preserve vision.
Keratoconus
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.
Keratoconus often begins to develop between the teen years and the early 20s, although it can develop at any age. Changes in the shape of the cornea occur gradually, usually over several years. Patients with keratoconus often experience blurred and distorted vision, nearsightedness, and a glaring sensitivity to light.
Early stages of keratoconus can be treated with eyeglasses or soft contact lenses. For progressive keratoconus, treatment methods include rigid gas-permeable contact lenses, INTACS (plastic implants that flatten the cornea), and collagen cross-linking (light-activated vitamin eye drops). If keratoconus persists, corneal transplant surgery can be performed to correct the condition.
Fuchs’ Dystrophy
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.
The cornea is made up of five different layers, each of which has a specific function that controls vision. The endothelium is the back layer of the cornea, which removes excess fluid from the stroma, the largest part of the cornea made up of water and collagen. Excess fluid can cause the stroma to swell and vision to become distorted.
When these cells deteriorate more rapidly than normal, fluid will continue to build up and vision will worsen. Once cells are lost, they do not grow back, so this condition will continue to progress with time.
Treatment
While there is no cure for Fuchs’ dystrophy, there are several treatment options available to help relieve the symptoms of this condition and to 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, Fuchs’ dystrophy may begin to interfere with daily activities and prevent patients from functioning normally. In this stage, patients may require a partial thickness corneal transplant (DSAEK) to replace the diseased back layer of the cornea and allow them to see clearly.
