CORNEA
Overview
Examples of common conditions that affect the
cornea
Overview
The cornea is the transparent tissue on the front part of the
eye. Not only is it important for the structural integrity of the
eye, but its curvature and clarity helps the eye focus. A healthy
cornea is required for normal vision. Diseases and injuries of the
cornea are an important cause of blindness in our community. All
physicians at EyeHealth Northwest are trained to diagnose and care
for patients with corneal problems. In addition, two fellowship
trained corneal specialists (Dr.
Roger Saulson and Dr.
Kerry Hagen) are on staff for consultation and surgery in difficult
cases.
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Examples of common conditions that affect
the cornea
Pterygium
Pterygium
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A pterygium
is a wing-shaped fibrovascular connective tissue that grows from
conjunctiva (a clear membrane that covers the white if the eye and
the inner eyelids) over the cornea. Sometimes referred to as a "Texas
cataract" (it is not a cataract), it is seen in individuals
who spend time outdoors such as farmers, fisherman and skiers. It
is felt that exposure to sun, wind, and ultraviolet light promotes
growth of this tissue. Conservative treatment includes artificial
tears and wearing sunglasses. If vision is affected, the tissue
can be surgically removed.
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Keratitis
Keratitis is a nonspecific term meaning inflammation
of the cornea. Keratitis can be caused by dry eye syndrome, contact
lens problems, inadequate eyelid closure and infections by bacteria
or viruses. Additionally, inflammation of the cornea can be associated
with systemic inflammatory disorders such as rheumatoid arthritis.
Herpes zoster (shingles) and the related herpes simplex virus also
commonly cause keratitis. Syphilis was a common cause of keratitis
in years past but fortunately is rare these days. Treatment of keratitis
depends on the cause but usually involves antibiotic and/or steroid
eye drops. Occasionally systemic treatment with an oral medication
is required as well.
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Corneal
Dystrophy
A corneal dystrophy is a bilateral (both eyes) abnormality
occasionally present at birth but more frequently appearing later
in life. Any of the five layers of the cornea can be involved. Of
the many known dystrophies, two deserve mention here:
- Anterior
Basement Membrane Dystrophy can cause recurrent corneal erosions,
poor healing of minor injuries, and blurred vision from an irregular
corneal surface. Dry eye syndrome worsens this condition. Treatment
options range from frequent artificial tears to superficial keratectomy,
to laser resurfacing of the eye with the excimer laser.
- Fuchs'
Corneal Dystrophy can cause corneal swelling later in life,
leading to
blurred vision,
painful erosions, and difficulty recovering from cataract surgery.
Corneal transplantation is occasionally necessary in advanced
cases.
Many rare dystrophies exist which may be difficult to diagnose
and require consultation by our corneal specialists.
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Keratoconus
Keratoconus
is an abnormality in which the symmetric curvature of the cornea
is distorted by abnormal thinning and forward bulging of the central
portion of the cornea (this is known as ectasia). This condition
is usually bilateral although one eye is often worse than the other.
Onset is usually at the time of puberty. Keratoconus progresses
slowly over many years, although it may become stationary at any
time. The main symptom is blurred vision, often not correctable
by glasses alone. Fortunately, most patients can obtain clear vision
with contact lenses. Our optometric staff is especially skilled
in contact lens fitting for this difficult problem. Corneal transplant
surgery is occasionally necessary in advanced cases. Refractive
surgery such as LASIK
is not helpful and can potentially worsen this condition.
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The cornea is
especially susceptible to injury. Foreign objects, abrasions, sports
injuries, and chemical burns can all lead to serious harm and even
blindness. Proper and timely care of an injured cornea is critical
to insure the best outcome. The doctors at EyeHealth Northwest work
closely with the Emergency Room staff at all of the major hospitals
in the Portland metropolitan area. An EyeHealth Northwest physician
is available for emergency call 24 hours a day. Answering service
operators are accessible through our clinic phone numbers after
hours.
Corneoscleral
laceration |
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