Your cornea is essential to clear, healthy vision. When disease or injury affects this vital structure, specialized care is critical. At Longwood Eye & LASIK Center, our experienced ophthalmologists diagnose and treat a wide range of corneal conditions, from blepharitis and dry eye to complex issues requiring surgical intervention.
What Is the Cornea?
The cornea is the clear structure at the front of the eye and, along with the white of the eye (the sclera), provides a barrier against dirt, germs, and other things getting into your eye. It even screens out some of the ultraviolet radiation that would otherwise enter your eye.
Beyond protecting the eye from foreign invaders, the cornea also plays a key role in your vision quality. Your cornea bends light as it enters your eye; the accuracy of this bending is how well you see objects at different distances.
How We Diagnose Corneal Diseases
At Longwood Eye & LASIK Center, we use a variety of tests and tools to diagnose diseases and identify problems with your cornea. Beyond a careful visual exam of your eyes and eyelids, and a review of your medical history, we’ll check the cornea with a slit lamp microscope. The slit lamp allows us to examine the anterior segment and posterior segment of the eye, including the eyelid, sclera, conjunctiva, iris, natural crystalline lens, and the cornea.
Additional testing may include:
- Topography and keratometry to study the shape of the cornea
- Pachymetry to measure the thickness of the cornea
- Microscopy to assess the health of the endothelial cells and identify infections
- Tear film assessment
Corneal Diseases and Conditions We Treat
The cornea can be affected by various diseases and conditions. The common causes of these are infections, trauma, degenerative disorders, autoimmune disorders, nutritional deficiencies, growths, ectasia (thinning), and allergies. At Longwood Eye & LASIK Center, we provide treatment and surgery for many of these diseases, including:
Blepharitis
Blepharitis is an inflammation of the eyelids. This usually occurs when tiny oil glands located near the base of the eyelashes become clogged. This irritates the eyes, making them red.
Several diseases and conditions can cause blepharitis, and it can be chronic and difficult to treat. Fortunately, it doesn’t usually cause damage to your vision.
Washing the eyes in warm water, with a focus on the eyelids, and using warm compressions can often help open these clogged glands. Beyond that, we may use prescription medications:
- Medications to address the infection: Antibiotics applied to the eyelids can resolve bacterial infections
- Medications to control inflammation: Steroid eyedrops and ointments can control inflammation
- Treatments for underlying conditions: Blepharitis caused by other issues, such as rosacea, seborrheic dermatitis, and other diseases, can be treated by targeting the disease to resolve the blepharitis
- Medications that target the immune system: Topical cyclosporine is a calcineurin inhibitor that can relieve this condition
Dry Eye
As the name implies, dry eye is a condition that occurs when your eyes don’t provide adequate lubrication. Your tears may be either of poor quality or you simply may not produce enough of them.
We offer comprehensive dry eye diagnosis and treatment options.
Recurrent Corneal Erosion Syndrome (RCES)
Recurrent corneal erosion syndrome is a common disorder involving the corneal epithelium (the outer layer) and the epithelial basement membrane.
This condition is characterized by repeated breakdown of the epithelium and causes moderate to severe eye pain, and can lead to corneal scarring and vision changes. The recurrent part of the title means this can happen even multiple times each week, where the epithelium erodes, regrows, and erodes again.
RCES can be caused by an old injury or abrasion of the eye, or an inherited eye disease.
Pterygium (Surfer’s Eye)
Pterygium is an eye condition that affects people who spend a lot of time outdoors. It involves the growth of pink, fleshy tissue on the conjunctiva (white part of the eye), usually on the side toward the nose.
The cause of pterygium is excessive exposure to ultraviolet light, dust, wind, sand, and humidity. Those characteristics lead to its colloquial name, surfer’s eye.
It is a non-cancerous growth that can develop slowly over time and may not present a threat to the patient’s eyesight, unless it covers the pupil of the eye. Only if it interferes with the patient’s eyesight is surgery needed. This is because pterygium tends to regrow.
During a pterygium excision, the pterygium is removed along with a portion of the surrounding conjunctival tissue. Then a tissue graft taken from the underside of the eyelid is placed on the excision site. It is placed with an adhesive mixture, usually thrombin and fibrinogen.
Instead of a conjunctival graft, freeze-dried human amniotic membrane tissue can also be placed onto the bare sclera. We place and adhere this to the sclera with fibrinogen.
Corneal Transplant Surgery (Penetrating Keratoplasty)
If the cornea has been damaged, a cornea transplant, clinically known as keratoplasty, may be necessary. A cornea transplant can restore vision, reduce pain, and improve the appearance of the damaged cornea.
Many conditions can merit a cornea transplant:
- Thinning of the cornea
- An outwardly bulging cornea
- Fuchs’ dystrophy
- Cornea scarring from infection or injury
- Clouding of the cornea
- Swelling of the cornea
- Corneal ulcers
The most common type of corneal transplant is called penetrating keratoplasty. Your Longwood Eye & LASIK Center surgeon uses an instrument known as a trephine to cut a small circular disc from the diseased or abnormal cornea.
Then, precisely measured donor cornea tissue is placed in the hole. This is known as a full-thickness corneal transfer. It is a very successful surgery with low risk.
Schedule A Consultation
If you are suffering from a corneal disease and would like to learn more about your surgical options, schedule an appointment at Longwood Eye & LASIK Center in Greenfield, MA, today!
Frequently Asked Questions
What causes most corneal problems?
The common causes include infections, trauma, degenerative disorders, autoimmune disorders, nutritional deficiencies, growths, ectasia (thinning), and allergies.
How successful are corneal transplants?
Penetrating keratoplasty is a very successful surgery with low risk when performed by experienced surgeons.
Will pterygium grow back after surgery?
Pterygium tends to regrow, which is why we use advanced techniques like conjunctival grafts or amniotic membrane grafting. Both methods have dramatically lower recurrence rates than older techniques.
Is corneal surgery painful?
Most corneal procedures are performed under local anesthesia with light oral sedation, so you won’t feel pain during the procedure. Some discomfort during recovery is normal and manageable with prescribed medications.
How long does recovery take after corneal surgery?
Recovery time varies depending on the specific procedure being performed. Your surgeon will provide detailed recovery instructions and a timeline during your consultation.
