Diagnosing and Treating Corneal Disease

Human eye cornea

Corneal Disease Symptoms, Diagnosis, and Treatments

Blurriness, pain, sensitivity to light, and other eye symptoms can occur if you have a disease that affects your cornea. The clear, curved layer of tissue covers your iris and pupil and focuses light rays on to the retina at the back of your eye. Changes to the cornea due to corneal disease can result in temporary or permanent vision problems. Fortunately, ophthalmologists offer a variety of treatments that can protect your vision.

Keratoconus

Keratoconus changes the curvature of the cornea, causing it to become cone-shaped. The change in the shape of the cornea may result in progressively worsening nearsightedness and astigmatism. Other symptoms can include sensitivity to glare and light. Keratoconus runs in some families but may also be caused by sun exposure, poorly fitting contact lenses, rubbing your eyes frequently, or long-term eye irritation.

Treatment: Eyeglasses and contact lenses can improve vision distorted by keratoconus. If soft contact lenses don't sharpen your vision, you may need harder gas permeable lenses, scleral lenses that rest on the white parts of your eyes, or hybrid lenses that feature a harder center and softer outside ring. Corneal cross-linking, a treatment that involves applying riboflavin drops to your cornea, then exposing it to ultraviolet light may stop the progression of the condition. Corneal transplants might be needed if scarring or thinning occurs.

Keratitis

This condition occurs when the cornea becomes painfully inflamed due to an ulcer, eye injury, infection, contaminated contact lenses, or wearing contact lenses longer than recommended. In addition to pain, you may notice redness, blurred vision, tearing, discharge, sensitivity to light, trouble opening your eye, or the feeling that something is stuck in your eye.

Treatment: Treatment varies depending on the cause of keratitis but may include artificial tears, eye drops to control pain, antibiotics, or anti-fungal medication. If the condition isn't treated promptly, permanent vision loss can occur.

Fuch's Dystrophy

Most common in people over age 50, this inherited corneal dystrophy causes deterioration in the endothelium, the layer of the cornea responsible for maintaining the optimal moisture level. When the cornea can no longer remove water efficiently, it begins to swell. The swelling causes blurred or foggy vision, particularly in the morning. Other symptoms can include glare, colored haloes around lights, pain, and difficulty seeing at night.

Treatment: Your eye doctor may prescribe a salt solution or ointment that removes excess water from your corneas. Surgery to replace the inner two-thirds of the cornea may be needed if the solution is no longer helpful.

Ocular Herpes

The same virus that produces cold sores can also cause sores on your corneas. Ocular herpes can also be caused by the sexually transmitted form of the herpes virus. The disease affects about 50,000 people in the U.S. every year, according to the American Academy of Ophthalmology. Just like cold sores, ocular herpes can occur more than once. Symptoms of ocular herpes include pain, tearing, sensitivity to light, blistering rash on your eyelids, headaches, and a foreign body sensation.

Treatment: Antiviral medication and eye ointments are used to treat ocular herpes. Steroid drops can help decrease inflammation.

Lattice Dystrophy

Abnormal protein fibers form a pattern in your cornea that looks like a lattice in this inherited corneal dystrophy. The disease can affect the clarity of your vision and cause painful corneal erosions, tearing and sensitivity to light. In many cases, lattice dystrophy is diagnosed during childhood or adolescence.

Treatment: Prescription eye drops, ointments, and bandage contact lenses can be helpful initially. If the disease is severe, your eye doctor may recommend laser treatment to reshape or remodel the cornea or a corneal transplant.

Diagnosing Corneal Disease

Your eye doctor may use one or more of these instruments and tests to diagnose corneal disease:

  • Slit-Lamp: During a slit-lamp exam, your ophthalmologist uses a low-powered microscope and a high-intensity light beam to examine your cornea and other parts of your eye. The exam can help your eye doctor diagnose corneal infections, abrasions, and abnormal changes.
  • Keratometer: This machine projects light on to the front part of your cornea and helps your ophthalmologist determine if your cornea is abnormally curved.
  • Corneal Mapping: Corneal mapping uses a computer to create a digital map of your cornea. The test provides valuable information on the surface and thickness of your cornea.

Your eye doctor can detect and diagnose early symptoms of many types of corneal diseases during annual eye examinations. If it's time for your exam, or you've been having trouble with your vision, call us to schedule an appointment.

Sources:

American Academy of Ophthalmology: Demystifying the Ocular Herpes Simplex Virus

Cleveland Clinic: Corneal Disease, 3/15/15

WebMD: Common Cornea Problems, 12/9/17

American Academy of Ophthalmology: What Causes Cornea Problems, 9/10/19

American Academy of Ophthalmology: Corneal Dystrophy Diagnosis and Treatment

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