Common causes of corneal problems

It is often said that the eyes are the window to your soul. But what happens when that window becomes blurry or even worse, the blinds are down, and you can’t see at all? This often happens when you have issues with your cornea, whether that be through injury, infection or disease. Below are some of the common problems people have with their cornea.

Keratoconus

Keratoconus effects many people, normally from a young age but can also occur later in life. Keratoconus causes the cornea to become thin and deform into a cone shape. This is gradual and happens over time with some sufferers of Keratoconus thinking that their distorted or blurred vision is normal. People with progressing Keratoconus generally have their glasses prescription changed or updated regularly as the cornea deforms and warps over time.

Keratoconus runs in families and can affect both eyes differently. Rubbing your eyes causes Keratoconus to progress more rapidly. Those suffering Keratoconus may not even be aware that they rub their eyes. Keratoconus can be stopped sometimes merely by ceasing eye rubbing. Collagen cross linking is available for mild cases of Keratoconus and can also stop the progression of Keratoconus. This is a simple procedure that is performed in the office.

If all else fails, then a layered corneal transplant or stromal corneal transplant is required. This type of corneal transplant can also be referred to as a DALK.

Fuchs dystrophy or cloudy cornea

Fuchs dystrophy or a cloudy cornea is when the cells on the back surface of the cornea (called endothelium) slowly deteriorate over time. These cells are what keep the cornea clear and as they fail, vision becomes cloudy.  

Fuchs dystrophy causes an accelerated loss of these endothelium which in turn makes the cornea cloudy and swollen. This process can be as little as a couple of months or over years with vision deteriorating over this time. Most patients with Fuchs dystrophy will complain of foggy vision in the morning which tends to get better as the day goes on.

Whilst Fuchs dystrophy can’t be stopped, we are able to treat the symptoms of Fuchs dystrophy. There are several eyedrops that can be used to treat discomfort, eye pressure and inflammation.

When the drops do not work, surgery is a viable option for suffers of Fuchs dystrophy with just this endothelial layer of the cornea being replaced in a layered corneal transplant or endothelial transplant. This type of corneal transplant can be referred to as a DMEK.

Herpetic Eye Disease

Herpetic eye disease is damage to the eye caused by one of the Herpetic group of viruses. This is a very common issue with most of the population over the age of 60 testing positive. It is typically seen as a cold sore. Significant damage to the front of the eye can be caused by the herpetic virus including corneal scarring and loss of vision. Other complications can include corneal ulcers, infection, and thinning of the cornea.

If Herpetic eye disease is active, then antiviral treatment is required. Sometimes anti-inflammatory medications are also required. Herpetic eye disease left untreated causes blindness. The earlier Herpetic eye disease is treated, the better the vision.

Pterygium

A Pterygium is  a visible corneal disease. A Pterygium is like a scar growing across the eye and can cause issues such as irritation, redness, discomfort and if left to grow long enough will cover the cornea and reduce sight. Because Pterygium can be seen by others (along with the associated symptoms) it can impact on social interactions as people believe that the state of your eyes is due to being tired, drunk or on drugs. There are also aesthetic concerns.

Having a Pterygium can sometimes be referred to as Surfers eye due to how it is formed. Many surfers and outdoor workers are at higher risk of a Pterygium forming due to exposure to UV rays (Australia has extreme UV), dust and wind. But a Pterygium can also come about as a result of an old injury, from previous surgery or even with immune disease.

To prevent a Pterygium, protect yourself from UV light damage, wind and dust. Using appropriate eye wear when outdoors.

Surgery is recommended for a Pterygium, when any of the above becomes a concern.

Corneal scarring

Scarring on your cornea causes an impairment of your vision. Sometimes scarring of the cornea creates glare, halo, double vision, multi focal vision, discomfort or simply distortion. It is a matter of correcting these irregularities on your cornea to improve your vision and this will normally requires laser surgery called Photo Therapeutic Keratectomy or PTK.

Corneal Injury

There are many ways that your cornea can be injured. It can be as simple as a fingernail scratch, hairbrush scratch or a foreign body such as a tree branch. A corneal injury can be quite painful and will generally take a few days to settle. This pain from a corneal injury can recur after the initial episode subsides.

Your corneal injury can be treated with ointments but if this fails, a simple office procedure can be performed and is very effective. Corneal polishing is performed in house and has a 99% success rate of rectifying a corneal injury. Whilst the cornea is relatively small, any loss in vision can have big effect on patients daily lives. Depending on your condition, there are non-surgical options available to prevent vision loss or slow it down. For the issues that are more progressed, surgery offers an avenue to restore or improve sight. A big part of my practice deals in advanced cornea and oculoplastic surgery and I like to break that down further for people and say surgery of the eyes and face. I like to believe that I have a unique and refreshing take on surgery and believe in old fashioned personal relationships with patients and referrers. If you are having a corneal issue and think we can help, then you can request an appointment online or call the clinic on 1300 393 322. We have 2 Sydney locations for consultation, Westmead and the city on Macquarie Street opposite the Eye Hospital.