Common Cornea Conditions

Keratoconus

Keratoconus is a condition in which the dome-shaped cornea progressively thins and weakens. This weakening allows the cornea to change shape, often bulging and becoming cone-like, which may result in blurry or distorted vision and increased light sensitivity.

Keratoconus is a part of a broader group of corneal-thinning conditions called corneal ectasia. Corneal ectasia conditions may be inherited, develop spontaneously, or be caused by repeated rubbing of the eyes.

Treatment options are focused on either decreasing the risk of disease progression or on improving the quality of vision. Adequate treatment typically requires that both of these aspects are addressed.

Treatments to decrease disease progression:

Treatments to improve the quality of vision:

  • Contact lenses (soft, rigid gas permeable, or scleral lenses)
  • Glasses (in very mild cases)
  • Corneal Intacs (typically combined with crosslinking)
  • Corneal transplantation
Cross-Linking for Progressive Keratoconus

Fuchs’ Dystrophy

Fuchs' dystrophy is a relatively common corneal dystrophy that affects the inner surface of the cornea, called the endothelium. These cells are responsible for pumping fluid from the cornea back into the eye. When the endothelium is unhealthy, the cells die and do not regenerate. This leaves dots called “guttata” on the inside of the cornea. These dots cause glare and decrease vision quality. Guttata are often the first sign of Fuchs' dystrophy.

If Fuchs' dystrophy progresses, the endothelial cells lose their ability to pump fluid out of the cornea, and the cornea swells. When fluid accumulates, the cornea can become thicker and hazy, like a steamy window, and can cause significant vision loss.

Treatment options include medications and cornea transplantation. Descemet’s stripping endothelial keratoplasty (DMEK) is widely considered the best surgery for Fuchs’, and it involves replacing just the dysfunctional endothelial layer with a healthy donor endothelial layer. This transplant is a single cell layer thick and offers excellent vision recovery.

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Fuchs’ Dystrophy: Overview

Dry Eye

Tears keep the eye moist, wash out dust and debris, and are essential to good eye health. Without this lubrication, vision blurs and the eyes become irritated and feel dry and scratchy. Dry eye is a chronic disease in which people experience varying levels of eye dryness, blurriness, itchiness, and burning due to insufficient quantity or quality of tears. Whether the dry eye discomfort is minor and occasional or frequent and debilitating, it can significantly affect your daily life and is one of the most common reasons people visit an eye doctor.

More than 85% of people diagnosed have evaporative dry eye. People with this form of dry eye produce tears that lack the lipid (oil) component needed to keep tears from evaporating too quickly.

Based on the cause of your condition, treatment may include one or a combination of options, including eye drops, supplements, hot compresses, and certain eye procedures.

Pterygium

Pterygium is a growth of the eye’s conjunctiva (white part of the eye). This growth is made of fleshy tissue, including blood vessels, and can remain small or grow larger.

Symptoms may include:

  • Blurry vision
  • Dry, itchy, burning eyes
  • Redness and swelling of the white part of the
  • Yellow spot or bump on the white part of the eye

Discomfort, redness, or swelling may be treated with lubricating or steroid eye drops. If a pterygium begins to affect your vision, surgery to remove it may be the best option.

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Pterygium: Overview

Corneal Scarring & Other Conditions Affecting the Front of the Cornea

Corneal scarring can result from a cornea injury, including abrasion, laceration, burns, or disease. Based on the degree of the scarring, vision may become blurry or be significantly reduced.

Other conditions or diseases can cause a lack of transparency in the front part of the cornea. These diseases often cause eye symptoms that can affect your ability to enjoy your daily life:

  • Dryness
  • Pain
  • Irritation
  • Irregular astigmatism

Surgery may be the most appropriate treatment option for those whose vision is not improved by non-surgical methods, such as medication or lubrication. Superficial keratectomy (SK) is one surgical option, but if the scarring is severe, a corneal transplant may be necessary to restore your best vision.