Let’s start by understanding what cornea is and what is its role when it comes to vision. A cornea is a clear, convex (dome-shaped) outer layer of eye that forms an important refractive surface where light rays enter and then focus on the retina. Furthermore, it also acts as a protective layer against dust, dirt, and germs.
There are many types of corneal problems that can affect your vision and cause problems with the cornea’s structure. Below are the two conditions that are most commonly seen in patients nowadays and effectively managed by the specialists at Centre for Sight.
A corneal ulcer is an open sore that occurs due to various reasons. Some reasons being infection, severe dryness of the eye, trauma, allergy, and incomplete eyelid closure. In all these cases, the bacteria or fungi enters cornea through minor erosions or abrasions and cause ulcer.
The occurrence of ulcer is more commonly seen in contact lens users. Common symptoms to look out for are decreased vision, redness of eyes, watering, swelling, pain and photophobia (extreme sensitivity to light).
Medical Management of Corneal Ulcer
If caused due to an infection, the first step of treatment is identification of microorganism causing this malady. A part of ulcer is mildly scraped for investigation. After identification, treatment targeted specifically at the causative agent is prescribed in form of eyedrops and many-a-times tablets.
Surgical Management of Corneal Ulcer
n uncontrolled corneal ulcer becomes a sight-threatening condition. In certain cases, surgical treatment is the only option left. If the ulcer is unresponsive to medical treatment or if the ulcer is large to begin with, a corneal transplant is done to save the eye. The purpose of corneal transplant here is to remove the microbiological load and prevent the infection from spreading to deeper structures of the eye.
It is a condition where the cornea progressively weakens and loses its dome-shaped structure to a conical shape. Keratoconus can be identified via symptoms of reduced vision, frequent change in glass power, double vision, high cylindrical number, and seeing halos & shadows around objects.
Causes include recurrent allergies or constant habit of eye rubbing. Mostly, Keratoconus starts from childhood and progresses upto the age of 30-32 years. Though in small percentage, it even progresses beyond this age.
First diagnosis of Keratoconus is the rapidly changing refractive error i.e. glass prescription. A dilated refraction accurately assesses this refractive error of each eye.
Conclusions to the severity of this condition can only be drawn by a Corneal Topography done by Pentacam. It shows the alterations of the cornea and helps the specialists draw a successful treatment plan for the patient.
Corvis-ST shows the extent of biomechanical weakening of the cornea that causes it to lose its original shape.
Patients with active or recurrent allergies are given anti-allergic treatments and are advised to avoid rubbing their eyes.
Corneal Collagen Crosslinking (C3R) halts the progression of Keratoconus. During the procedure, cornea’s top layer is scraped to instill riboflavin drops and soak cornea for 20-30 min. Prior to this, UV-A radiation exposure is concentrated on patient’s eyes for 10 minutes. Once done, eye is washed and contact lens is placed over cornea to be worn for 3-4 days.
PMMA ring segments insertion into corneal stroma for alteration of the shape of cornea is known as INTACS. This procedure assists in regularizing & flattening of the corneal shape and is generally advised in cases of eccentric cones (diagnosed through Pentacam) or high astigmatism. INTACS is performed along with C3R in same sitting.
Conservative management methods might not prove complaint in the advanced cases of Keratoconus. As a last resort in such cases , corneal transplant is advised. Available state-of-the-art options include Deep Anterior Lamellar Keratoplasty (DALK) i.e. a Partial Thickness Transplant or Full-Thickness/Penetrating Corneal Transplant (PK). Specialists decide on the choice of the transplant procedure depending on the corneal condition and depth of the scar created by keratoconus.
- Medical Management
- Corneal Collagen Cross-linking
- Corneal Transplant
Cornea Surgery at Centre for Sight
The expert surgeons at Centre for Sight see and manage many complex corneal cases daily. All our specialists have been dealing with these corneal diseases from several years and have helped the patients regain a healthy vision.
After the consultation, our highly trained and experienced doctors evaluate the overall situation and give a solution based on the patient’s situation and budget. If patients consent and the doctor insists, the recourse of cornea surgery is undertaken to restrict the infection from hampering their vision and overall health of their body.
Is corneal damage permanent?
Corneal damage may or may not be permanent depending upon the disease.
How long does corneal transplant last?
Corneal transplant once done, lasts lifelong if the graft is accepted by the body. However, in cases of graft rejection or failure, repeat surgeries may be required.
How long one has to wait for a corneal transplant?
The eye bank arranges for donor corneal tissue. Patients may have to wait for the availability for a healthy donor cornea of the appropriate age and good quality for some time.
Are corneal transplants successful?
Yes. Corneal transplants are successful. Certain medicines are prescribed to aid in the acceptance and survival of the graft.
Can a corneal transplant cure glaucoma?
Corneal transplant does not cure glaucoma.
How do I know if I need a corneal transplant?
The consulting ophthalmologist would determine whether you need a corneal transplant or not.
What happens if I scratch the cornea?
Corneal traumas in the form of abrasions occur. These abrasions may get infected and cause ulcer if not treated in time.
Is a corneal abrasion an emergency case?
Yes, it is. It is a painful condition and needs urgent attention before it gets infected and forms a corneal ulcer.
How much time does corneal abrasion takes to heal?
Depending on the size of the abrasion, it may take 24-73 hours to heal.
Can a corneal abrasion cause permanent damage?
Usually corneal abrasion heals without any permanent damage, provided it is not infected.
Can you go blind by Keratoconus?
Advanced Keratoconus may reduce the vision to an extent where daily routine activities may become difficult.
What is the best treatment for Keratoconus?
There are various treatment options available depending on the severity of Keratoconus.
Can Keratoconus be reversed?
No. It cannot be reversed, however its progression can be halted.
Can Keratoconus be cured permanently?
Most patients undergoing C3R have a stable Keratoconus.
Is Keratoconus serious?
It is a sight threatening condition that warrants timely treatment as it is known to progress with time.
Can Keratoconus go away on its own?
Keratoconus cannot go away on its own. However, in the patients above 32 years of age it may stabilize in its own.
Can Keratoconus patients wear glasses?
Yes. Keratoconus patients can wear glasses to gain optimal vision.
Does corneal transplant cure Keratoconus?
Yes, it does.
Is Keratoconus a disability?
Yes. Certain cases of Keratoconus may have visual disability.
Can laser eye surgery correct Keratoconus?
Laser surgery doesn’t correct Keratoconus. C3R halts Keratoconus progression.
Is Keratoconus rare?
Keratoconus is a fairly common disease seen amongst young population aging below 30 years. It is fairly common in patients having the habit of rubbing their eyes.