Patient Education :
Common disorders of The Cornea:
- Dry Eyes
- Corneal Scar
- Corneal dystrophy
- Corneal Infections
- Ocular surface disorders
Dry eye syndrome:
Dry eyes can result either from a reduced tear production from the tear glands or excessive evaporation of the tears from the eye. Inflammation of the eyelids (blepharitis) or prolonged exposure of the eyes to dry, cool surroundings, is the most common culprit. It is also seen in the elderly, with history of diabetes, arthritis, and those on certain long term medications. Most of the patients with “Dry eyes” complain of burning, stinging, itching, gritty sensation in the eyes, dryness, soreness, heaviness of the lids, light sensitivity and/or “tiredness of the eyes”. Symptoms are often worse at the end of the day and can be aggravated by certain activities (e.g. reading, watching television, and working on the computer) and certain surroundings (e.g. airplane cabins, air conditioned rooms, smoky rooms.) Treatment of dry eye involves multiple modalities including lubricants, tear stimulation, punctual occlusion etc.
A pterygium is a growth of tissue onto the surface of the cornea, often a result of prolonged sun exposure (UV rays). It commonly causes redness, irritation and if large enough, even decreases vision. A pterygium causing too many symptoms requires surgical removal. Pterygium excision is a simple 10 minute day care procedure. After removing the pterygium, a conjunctival graft is placed in the bare area which can be held in place by using just surgical glue without the need for any sutures! This graft prevents recurrence of pterygium after it has been excised.
Keratoconus is progressive condition characterized by weakening of the cornea wherein the cornea (the outer clear part of the eye) becomes “cone-shaped”, instead of being spherical. It is said to happen when the corneas are less “rigid”. Keratoconus typically develops between the ages of 12 and 25 years and results in progressive reduction in vision. Early cases can be treated with rigid contact lenses, while those who can’t tolerate contact lenses at all, may require a corneal transplant. Recently, a technique to arrest its progression has also been introduced. Corneal collagen cross-linking of the cornea with Riboflavin (C3R) is available to increase the rigidity of the cornea thus arresting its progression. (To Read more about Keratoconus click here)
Corneal scars are usually formed following trauma or corneal infections and if it is dense enough can cause obscuration of vision. Depending on the density, location and thickness of scar, either a laser or corneal transplantation can be performed to remove the scar and restore vision.
These are hereditary group of disroders that can cause opacification of the cornea and progressive decline in vision. If a family member has this disorder, it is advisable that the close relatives get screened for this disorder by a simple ophthalmic examination. Corneal dystrophies can be successfully managed using lamellar corneal transplantation.
Corneal infections occur usually following trauma and can be bacterial, fungal or viral infections. They present with sudden onset of pain, redness and decline in vision. These infections need to be diagnosed and treated early. Samples are taken and a detailed microbiological work up is done. Milder infections can be treated with drops and more severe infections may require a therapeutic keratoplasty.
Ocular Surface Disorders:
A number of ocular surface disorders like ocular Steven Johnson syndrome, Chemical injuries, Ocular Cicatricial Pemphigoid & Neurotrophic Corneas require very specialized care. At the Eye Foundation we offer the entire gamut of complicated procedures for treating these difficult set of disorders ranging from Limbal stem cell transplantation, Amniotic membrane transplantation, Mucous membrane grafts and in some extreme cases replacing the entire cornea with an artificial carrier called Keratoprosthesis.
Procedures & Services:
Pentacam Tomography – the latest and most advanced three dimensional tomographer which accurately images the cornea and screens patients for Lasik and Keratoconus.
- Pachymeter – to calculate thickness of the cornea
- Aberrometer – to measure internal aberrations of the eye
- Specular microscope – to assess the health of the inner layer of the cornea (endothelium)
- Ocular Response Analyser – the rigidity of the cornea can be measure indirectly through this advanced scan
- Dry Eye Work up – Set of investigations to evaluate the extent and cause for dry eye
- Microbiology work up – For identifying specific microbes in corneal infections
- Corneal Transplantation – Full thickness & Lamellar (provide hyperlink)
- Keratoprosthesis – Artificial Corneal transplantation
- Amniotic membrane transplantation
- Pterygium excision with conjunctival autograft
- Limbal stem cell transplantation
- Ocular surface reconstruction
- Mucous Membrane grafting
Full Thickness Penetrating Keratoplasty