What is Corneal Disease?
If we think about the eye as a camera, the cornea would be the glass at the front of the camera lens. The cornea is not only a clear window through which light passes on its way into the eye, it provides most of the focusing power in the eye as well. The normal cornea is clear, transparent and dome-shaped. A corneal disease can cause a loss of transparency, swelling, scarring, thinning or irregularity of corneal shape, all of which can reduce visual acuity or distort vision and sometimes result in blindness. There are many types of corneal disease. Some of the more common are Keratoconus, Fuchs’ endothelial dystrophy, bullous keratopathy, corneal infections and other corneal dystrophies.
Keratoconus is a weakening and thinning of the central cornea. The cornea develops a cone-shaped deformity. Progression can be rapid, gradual or intermittent. Keratoconus usually occurs in both eyes, but can occur in only one eye. As the cornea protrudes or steepens, vision becomes increasingly blurred and wearing lenses, which is often an early treatment for the disease, becomes difficult. The contact lens may not stay on the eye due to the irregular shape of the cornea.
Fuchs’ endothelial dystrophy is a hereditary abnormality of the inner cell layer of the cornea called the endothelium. The purpose of this layer is to pump fluids out of the cornea, keeping it thin and crystal clear. When the endothelium is not healthy, fluids are not pumped out and the cornea develops swelling, causing it to become cloudy and decrease vision. A person with Fuchs’ endothelial dystrophy or bullous keratopathy may first notice glare with lights at night or in bright sunlight. As these conditions progress, vision may be foggy or blurry in the morning and clear up as the day progresses. As the diseases further progress, vision will stay blurrier later into the day and eventually may not clear at all.
Bullous keratopathy is a condition in which the cornea becomes permanently swollen. This occurs because the inner layer of the cornea, the endothelium, has been damaged and is no longer pumping fluids out of the tissue. As the cornea continues to swell, it may develop blisters on the surface which can rupture and cause severe pain.
Our doctors can check for corneal disease and trauma by examining your eyes with magnifying instruments. Using a slit lamp and advanced diagnostic technology such as corneal topography, we can detect early cataracts, corneal scars and other problems associated with the front structures of the eye. With a dilated exam, our doctors will also examine your retina for early signs of disease.