Corneal Services
CORNEAL
Corneal disease can range from the simple to the complex. In the event that you have a complex problem requiring advanced medical or surgical care Ophthalmologist’s James Castner, Kevin Dinowitz and James Pasternack are ready to serve you.
The cornea is the clear front window of the eye. It transmits light to the interior of the eye allowing us to see clearly. Corneal diseases can cause clouding and distortion of vision, and eventually blindness. There are many types of corneal disease.
Infections related to contact lenses, abrasions from trauma, and inflammation are common. Other conditions includekeratoconus, Fuchs’ endothelial dystrophy, and pterygia among many others.
As with any serious eye infection, corneal disease should be treated immediately. There are antibiotics and steroids that can be used topically, and occasionally by mouth, to treat the myriad of conditions that can affect the cornea.
It is important NOT to use a friend’s eye drops or Visine like drops without consulting your ophthalmologist. A corneal transplant is sometimes necessary to restore vision when the cornea becomes clouded, but newer advances like Endothelial Keratoplasty or DSAEK may also be employed in certain cases to help restore vision.
It is important NOT to use a friend’s eye drops or Visine like drops without consulting your ophthalmologist. A corneal transplant is sometimes necessary to restore vision when the cornea becomes clouded, but newer advances like Endothelial Keratoplasty or DSAEK may also be employed in certain cases to help restore vision.
Layers of Corneal
Treatment for corneal disease:
Epithelium: The most superficial layer of the cornea, the epithelium stops outside matter from entering the eye. This layer also absorbs oxygen and nutrients from tears.
Stroma: The stroma is the thickest layer of the cornea and is found behind the epithelium. It is made up mostly of water and proteins that give it an elastic but solid form.
Endothelium: The endothelium is a single layer of cells located between the stroma and the aqueous humor, the clear fluid found in the front of the eye. The endothelium works as a pump, expelling excess water as it is absorbed into the stroma. Without this specialized function, the stroma could become waterlogged and hazy and opaque in appearance, also reducing vision.
Causes of corneal disease:
- Infection: Bacterial, fungal and viral infections are common causes of corneal damage.
- Heredity
- Eye trauma
- Certain systemic diseases
Diagnosing corneal disease:
Your eye doctor can check for corneal disease and trauma by examining your eyes with magnifying instruments. Using a slit lamp and advanced diagnostic technology such as corneal topography, your doctor can detect signs of corneal infection, inflammation, scarring, and other problems associated with the front structure of the eye. A special dye may be used to determine the extent of the damage.
What conditions can damage the cornea?
Keratitis
This is an inflammation of the cornea that sometimes occurs with infection after bacteria or fungi enter the cornea. These microorganisms can enter the eye after deep injury, causing infection, inflammation and ulceration of the cornea. Though uncommon, this type of infection can also arise after injury from wearing contact lenses.
Symptoms of keratitis include:
- Severe pain.
- Reduced visual clarity.
- Corneal discharge.
- Light sensitivity.
Ocular herpes (herpes of the eye)
This is a viral infection of the eye that may reoccur (return). The main cause of ocular herpes is the herpes simplex virus I (HSV I). This is the same virus that causes cold sores, but ocular herpes can also result from the sexually transmitted herpes simplex II virus (HSV II) that causes genital herpes.
Ocular herpes produces sores on the surface of the cornea that can lead to scarring and reduced vision.The inflammation can spread deeper into the cornea and eye. There is no cure for ocular herpes, but it can often be controlled with the use of antiviral drugs.
Ocular herpes produces sores on the surface of the cornea that can lead to scarring and reduced vision.The inflammation can spread deeper into the cornea and eye. There is no cure for ocular herpes, but it can often be controlled with the use of antiviral drugs.
Herpes zoster (shingles)
Shingles is a recurrence (return) of the chickenpox virus in people who have already had the disease. After the bout of chickenpox, this virus usually remains inactive within the nerves of the body. It can later travel down these nerves, infecting specific parts of the body, like the eye. Herpes zoster can cause blisters or lesions on the cornea, fever and pain from affected nerve fibers.
Corneal lesions usually heal by themselves, but antiviral treatment may shorten the course of disease. Some people develop chronic inflammation of the cornea after shingles requiring use of long-term eye drops, or less commonly, corneal surgery.
Shingles can occur in anyone exposed to the chickenpox virus, but there’s an increased risk in older adults (especially those over age 65) and people with a weakened immune system.
See your ophthalmologist if you have any symptoms of shingles near or in the eye.