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  • Dr. Akash jain

Corneal Diseases

Understanding the Clear Window of Your Eye

The cornea is the clear, dome-shaped front surface of your eye that plays a crucial role in focusing light onto the retina, giving you sharp vision. Any disease affecting the cornea can significantly impact vision, causing blur, glare, distortion, or even permanent vision loss if not managed properly.

Corneal diseases often progress silently, and timely diagnosis and treatment are essential to protect vision. At Vision & Beyond, we specialize in advanced corneal diagnostics and treatment, ensuring precise care for every condition.

Common Corneal Diseases You Should Know
Keratoconus – The Progressive Corneal Thinning Disorder

Keratoconus is a condition where the cornea becomes progressively thin and bulges outward into a cone-like shape, distorting vision. It usually starts in adolescence or early adulthood and worsens over time.

Symptoms of Keratoconus
  • Blurred, distorted vision.
  • Increased sensitivity to light and glare.
  • Frequent changes in glasses prescription.
  • Ghosting or double images.
  • Difficulty seeing at night.
Diagnosis of Keratoconus
  • Corneal Topography: 3D mapping of the corneal surface.
  • Pachymetry: Measures corneal thickness.
  • Corneal Tomography (Pentacam): Advanced imaging for early detection.
Latest Treatments for Keratoconus:
  • Corneal Collagen Cross-Linking (C3R): Strengthens corneal fibers to halt progression.
  • Intracorneal Ring Segments (ICRS): Tiny implants that flatten the cornea and improve vision.
  • Customized Contact Lenses: Rigid Gas Permeable (RGP), Scleral lenses.
  • Topography-Guided PRK with C3R: Corrects corneal shape and strengthens it simultaneously.
  • Corneal Transplant (DALK / PKP): Reserved for advanced cases.
Keratitis – Inflammation or Infection of the Cornea

Keratitis refers to inflammation of the cornea, which can be infectious (bacterial, viral, fungal, parasitic) or non-infectious (due to injury, dry eyes, or contact lens overuse).

Symptoms of Keratitis
  • Redness and irritation.
  • Pain or foreign body sensation.
  • Watering and light sensitivity.
  • Blurred vision.
  • Discharge (in infectious keratitis).
Common Causes of Keratitis
  • Bacterial Keratitis: Often linked to contact lens misuse.
  • Viral Keratitis: Usually caused by the Herpes Simplex Virus (HSV).
  • Fungal Keratitis: Often seen in agricultural injuries.
  • Acanthamoeba Keratitis: A rare, severe infection linked to contaminated contact lenses.
Diagnosis of Keratitis
  • Slit-Lamp Biomicroscopy.
  • Corneal Scrapings for Microscopy and Culture.
  • PCR testing for viral DNA in persistent cases.
Treatment of Keratitis
  • Topical Antibiotics / Antivirals / Antifungals based on the causative organism.
  • Steroid Drops (with caution) for non-infectious or post-infectious inflammation.
  • Corneal Debridement or Therapeutic Contact Lenses for healing.
  • Amniotic Membrane Grafting in non-healing ulcers.
  • Emergency Corneal Transplant in severe perforations or non-responsive infections.
Corneal Dystrophies – Genetic Clouding of the Cornea

Corneal Dystrophies are hereditary conditions where abnormal material builds up in the cornea, causing cloudiness and vision problems. They are usually bilateral and progressive.

Common Types of Corneal Dystrophies:
  • Fuchs’ Endothelial Dystrophy: The inner layer of corneal cells deteriorates, leading to corneal swelling and blurred vision.
  • Lattice Dystrophy: Deposits of amyloid in the corneal stroma.
  • Granular Dystrophy: White opaque granular deposits.
  • Map-Dot-Fingerprint Dystrophy (EBMD): Irregularities on the corneal surface causing recurrent erosions.
Symptoms of Corneal Dystrophies
  • Blurred vision.
  • Glare, halos.
  • Recurrent corneal erosions (pain, watering upon waking).
  • Progressive decrease in vision.
Diagnosis of Corneal Dystrophies:
  • Slit-Lamp Examination.
  • Specular Microscopy (especially for Fuchs’ Dystrophy).
  • OCT of Cornea.
  • Genetic Testing in certain cases.
Treatment of Corneal Dystrophies:
  • Lubricating Eye Drops & Ointments for symptom relief.
  • Hypertonic Saline Drops/Ointments to reduce corneal swelling.
  • Anterior Stromal Puncture / PTK (Phototherapeutic Keratectomy) for recurrent erosions.
  • Endothelial Keratoplasty (DSEK / DMEK): Partial corneal transplant for Fuchs’ Dystrophy.
  • Full Thickness Corneal Transplant (PKP) in advanced cases.

Frequently Asked Questions (FAQs)

  • What are the common signs of corneal diseases

    Symptoms include:
    • Blurred or hazy vision.
    • Eye redness and irritation.
    • Sensitivity to light.
    • Eye pain or discomfort.
    • Foreign body sensation.
    • Frequent prescription changes.

    Any of these symptoms warrant an urgent eye examination.

  • How is Keratoconus detected?

    Keratoconus is diagnosed using corneal topography or tomography, which maps the curvature and thickness of the cornea in detail. Early detection through routine eye check-ups is crucial.

  • Can Keratoconus be cured?

    While keratoconus cannot be “cured”, Corneal Collagen Cross-Linking (C3R) can stop its progression. Vision can be improved with specialized contact lenses or surgical options like ICRS or corneal transplants in advanced stages.

  • Is Keratitis serious?

    Yes. If untreated, infectious keratitis can cause permanent scarring, perforation, and vision loss. Early diagnosis and targeted treatment are essential for a good outcome.

  • What should I do if I suspect a corneal infection?

    Seek immediate consultation. Avoid self-medication. A prompt corneal scraping and lab testing will help identify the infection and guide treatment.

  • Are corneal dystrophies hereditary?

    Yes, most corneal dystrophies are genetically inherited. A family history increases the risk, but not all individuals will develop vision-threatening forms.

  • Can corneal dystrophies be managed without surgery?

    Mild cases are managed with lubricants, hypertonic saline, or minor procedures like PTK. Surgery (keratoplasty) is reserved for advanced cases where vision is severely affected.

  • How is a corneal transplant performed?

    A corneal transplant (keratoplasty) involves replacing the diseased or damaged part of the cornea with healthy donor tissue. Depending on the condition, either a partial thickness (DALK/DSEK/DMEK) or full-thickness (PKP) transplant is performed.

  • Can dry eyes cause corneal problems?

    Yes, severe dry eye can lead to exposure keratitis, recurrent erosions, and in chronic cases, even corneal ulcers. Proper diagnosis and management of dry eye are critical.

  • How often should I get my cornea checked?

    • For individuals with contact lens usage, family history of keratoconus, or prior corneal infections: annual check-ups are recommended.
    • If you have known corneal dystrophies or keratoconus, follow-up frequency depends on severity, typically every 6 months to 1 year.
Takeaway: The Clear Window to Your Vision Needs Protection

Corneal diseases can silently affect your vision and quality of life. At Vision & Beyond, we offer comprehensive corneal diagnostics, advanced imaging, and the latest treatments to ensure your vision remains clear and protected.