Your eyes are an open window to the world. Just in front of each eye is a small, highly functional dome-shaped structure known as the cornea, which is a clear dome that shields your eye and aids in vision.
If it malfunctions, everything fuzzes -literally.
What is Corneal Disease?
Corneal Disease is an overall term for a group of diseases affecting the clear window. Some are mild. Some are serious. Each of these should be taken into consideration.
Your cornea performs two major functions. It forms a physical barrier which helps to prevent dust and other particles entering your eye. It also focuses light, which allows you to see through.
Both of these tasks are affected by corneal disease. There are not just one condition, it is a family of conditions. Others are due to infections. Some are due to hereditary factors. Others occur after an injury to or surgery on the eye.
The tricky part? In some corneal diseases there are obvious warning signs. Others sneak in without a hint of pain or redness, before your vision is impacted.
This is why it is vital to have regular eye exams.
Types of Corneal Disease
A corneal disease affects the front surface of an eye. There are various types of corneal disease that a person can encounter
1. Keratitis -Inflammation of the Cornea
Keratitis refers to an inflammation of the cornea. Can be contagious or non-contagious.
Bacterial, viral, fungal, or parasitic causes are responsible for infectious keratitis. When it's infectious, it's also called a corneal ulcer - an open sore on the surface of your eye. This is a medical emergency. Wisely, the treatment of the corneal ulcer should always be commenced at the earliest opportunity to avoid permanent loss of vision.
Non-infectious keratitis is caused by trauma, dry eye or underlying disease. Either way, keratitis is a painful condition that requires swift treatment.
2. Keratoconus Eye Disease -When the Cornea Bulges
One of the most discussed eye diseases is keratoconus. During this stage, the cornea slowly becomes thin and begins to project outward like a cone. It is no longer round and smooth, but irregular -and your vision is thrown off.
Keratoconus usually starts in the teenage years or early adulthood. Problems start to gradually get worse over time. Glasses can correct the blurriness of vision as early as the beginning. However, the conical shape continues to develop, and eventually patients must use special contact lenses or undergo surgery.
Keratoconus eye disease is a type of a larger group of diseases known as corneal ectasia, or disorders of the cornea. Ectasia may also occur as a side effect of LASIK eye surgery.
3. Corneal Dystrophy -The Genetic Cause
Corneal dystrophy is a family of corneal diseases. They are caused by abnormal deposits that form in the layers of the cornea, which include protein, fluid, or other substances that should not be present in the cornea.
There are types of corneal dystrophy that are not severe and do not pose a problem. Others, however, are progressive and can have a serious detrimental impact on vision over time.
The most common type is Fuchs dystrophy. As cells of the deeper layer of the cornea in Fuchs dystrophy degenerate, the cornea swells. Some patients may experience poor vision in the morning, which may improve throughout the day. There are other types, such as lattice corneal dystrophy and granular corneal dystrophy.
If your family history includes corneal dystrophy – notify your eye doctor. It can be detected early with genetic screening.
4. Other Corneal Conditions
- Abrasion of the cornea-A scratch on the surface of the cornea. Typically due to a fingernail, foreign body, or extreme dry eye. Heals rapidly but is painful.
- Herpes virus (yes, the one that gets you cold sores) infection of the eye. It makes a person feel pain, become red, and sensitive to light.
- Bullous Keratopathy- Blisters and swelling of the cornea, usually associated with eye surgery or corneal dystrophy.
- Pterygium- A fleshy growth on the white of the eye that may grow onto the cornea and sometimes cause scarring.
Signs & Symptoms -What to Watch For
The signs and symptoms associated with corneal infections depend on the infection. Here are the most typical red flags, however:
- A pain in the eye that may be mild or severe
- Light sensitivity, including discomfort with normal indoor lighting
- Blurred or hazy vision, which is also known as 'out of focus'.
- Watery eyes – excessive tearing without reason
- Red or bloodshot eyes – if the redness does not resolve after a few days
- A gritty or scratchy feeling in your eye, a feeling of something being in your eye.
Discharge or pus (may indicate infection)
In some cases, particularly when the condition is early, or keratoconus, there is no apparent change in the cornea. That is why it is so important to get an eye exam with a specialist even if you don't experience any signs or symptoms.
What Causes Corneal Disease?
Corneal diseases don't have one single cause. They develop from a range of triggers:
- Infection.
- Injury or trauma to your eye
- Genetic mutations
- Other eye conditions
- Certain medical conditions
Which Patients are at Highest Risk of Corneal Disease?
You would develop this disease if you
- Wear contact lenses (particularly at night time)
- Have a compromised immune system
- Frequently rub your eyes
- Suffer from allergies, eczema or hay fever
- Have previously undergone eye surgery
- Have a family history of corneal disease
How Is It Diagnosed?
An eye care specialist will run a full eye exam. The key tool they use is a slit lamp exam -a high-powered microscope that lets the doctor look at your cornea in fine detail, layer by layer.
They may also use a fluorescein eye stain test. A small amount of harmless orange dye is placed in your eye. Under blue light, any scratches, ulcers, or damage on the cornea glow clearly. It's quick, painless, and very effective for spotting corneal infection symptoms and surface damage.
For conditions like keratoconus, a corneal topography scan may be done -it maps the exact shape and curvature of your cornea.
Treatment Options
Here's the good news: most corneal diseases can be treated. How they're treated depends on the specific condition and how advanced it is.
- Medications- Eye drops with antibiotics, antivirals, or antifungals- are used in infections. Anti-inflammatory drops are used to treat keratitis and herpetic eye disease.
- Glasses or Special Rigid Contact Lenses- In cases of early keratoconus eye disease, corrective lenses may be able to give good visual acuity without surgery.
- Laser Procedures- Phototherapeutic keratectomy (PTK): A laser is used to gently reshape or smooth the cornea. It is administered when the cornea is scarred, irregular, or has dystrophy.
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Corneal Transplant Surgery- If the cornea is so damaged or diseased that it can't serve its purpose, corneal transplant surgery is a procedure in which the damaged cornea is replaced with tissue from a donor. One of the most frequently performed and effective transplantations in the world.
Corneal transplants come in various types, depending on the type of cornea being affected. For some, the damaged inner or outer corneal layer is replaced, rather than the entire cornea. While recovery is a process that takes time, outcomes are typically very good.
- Artificial Cornea- It happens in rare instances when it is not possible to have a regular corneal transplant. Surgeons can replace the cornea with an artificial cornea, called a keratoprosthesis. This is only used for serious and complicated cases.
Is There a Way to Prevent Corneal Disease?
Not necessarily - particularly if it's genetic. However, there is a way to reduce your risk:
- Use protective eyewear when playing sports and when handling tools and chemicals.
- Practice good contact lens hygiene - clean, store properly, do not sleep in contact lenses
- Do not share eye makeup or contact lens solution.
- See a doctor immediately if something gets stuck in your eye -don't try to remove it yourself
- Share information with your eye doctor about corneal disease in the family.
Frequently Asked Questions (FAQs)
Q: Which is the most common corneal disease?
Common corneal problems around the world include keratitis (inflammation of the cornea) and Fuchs corneal dystrophy.
Q: Is corneal disease treatable?
There are numerous corneal diseases that can be treated and controlled. However, certain eye problems, such as corneal ulcers, can be treated with medicines. In other cases, such as in advanced keratoconus or corneal dystrophy, patients may require corneal transplant surgery.
Q. What are the signs of the most common corneal infections?
Common symptoms are eye pain, redness, sensitivity to light, watery eyes, blurred vision, and discharge or pus. If these occur, seek treatment right away.
Q: Is keratoconus eye disease very serious?
If left untreated, it can be. With time, keratoconus can create vision problems and can develop slowly. If caught early, it's very manageable, either with the right lenses or procedures.
Q: Does the recovery from corneal transplant surgery vary?
Recovery depends on the type of transplant. Complete recovery of vision may take from a few months to a year. Patients make a lot of improvement before they are fully healed.
Clinical Evaluation
The term “corneal disease” is a frightening term. However, early diagnosis can make a huge difference. From corneal ulcers to keratoconus eye disease, an effective lens and corneal transplants -there are real options for effective treatment at every step.
Don't ignore your eyes. Get an eye care specialist's checkup regularly. Vision is worth so much.
At Himalayan Eye Institute, our corneal specialists offer comprehensive diagnosis and advanced treatment -from targeted medical therapy to corneal transplant surgery. Your vision deserves expert care.