Corneal Disease & Disorders

The cornea is a dome-shaped transparent window covering the front of the eye.

Through it, light is focused to the retina inside of the eye and it is this process that allows us to see clearly. Corneal disease is a very serious condition that, when left untreated, can cause clouding, distortion and eventually blindness. There is more than one type of corneal disease and disorder. The three major types are known as bullous keratopathy, Fuchs’ endothelial dystrophy, and keratoconus.

BullousKeratopathy

Bullous Keratopathy

Symptoms of Corneal Disease

  • In Bullous keratopathy, the cornea becomes permanently swollen because the Savener layer of the cornea (the endothelium) has been damaged and is no longer pumping fluids out of the tissue.
  • Fuchs’ endothelial dystrophy, a hereditary abnormality, happens in the inner cell layer of the cornea called the endothelium. This layer has the purpose of pumping fluids out of the cornea to keep it thin and crystal clear. In an unhealthy endothelium, fluids are not pumped out, the cornea swells, causing it to become cloudy, and decreased vision immediately follows.
  • With Fuchs’ endothelial dystrophy or bullous keratopathy, a person often first notices a glare with lights at night or in bright sunlight. When these conditions progress, vision may become foggy or blurry in the morning, but vision is clearer as the day progresses. When the disease progresses further, vision will stay blurrier later into the day and eventually may not clear up at all.
  • With keratoconus, a weakening and thinning of the central cornea, the cornea progressively protrudes or steepens causing vision to become increasingly blurred; and, the ability to wear contact lenses (which is often an early treatment for the disease) becomes difficult. This is because the contact lens may not stay on the eye due to the irregular shape of the cornea. Progression can be intermittent, gradual, or rapid. This condition most commonly occurs in both eyes, but can occur in only one eye.
  • Some corneal diseases can be very painful.

Causes of Corneal Disease

  • Infection: Bacterial, fungal and viral infections are common causes of corneal damage.
  • The cause of keratoconus in most patients is unknown.
  • Age: Aging processes can affect the clarity and health of the cornea.
  • Cataract and intraocular lens implant surgery: Bullous keratopathy occurs rarely in patients after these procedures.
  • Heredity
  • Contact lenses
  • Eye trauma
  • Certain eye diseases, such as retinitis pigmentosa, retinopathy of prematurity, and vernal keratoconjunctivitis
  • Systemic diseases, such as Leber’s congenital amaurosis, Ehlers-Danlos syndrome, Down syndrome and osteogenesis imperfecta.

Diagnosing Corneal Disease

Using advanced diagnostic technology such as corneal topography, as well as more traditional equipment such as slit lamp, Dr. Singh routinely checks for corneal disease, corneal scars, early cataracts, and other conditions or problems associated with the front structures of the eye (including trauma) by examining his patients’ eyes carefully and thoroughly.

After dilating your eyes, Dr. Singh will also examine the retina for early signs of disease.

Treatment for Corneal Disease

As with any serious eye infection, corneal disease should most definitely be treated immediately. Although corneal transplant is the only treatment available to restore vision once the cornea has become clouded, other measures exist that can prolong vision in the early stages of disease.