About

The cornea is the clear window at the front of the eye. Being completely transparent and rounded in shape, it’s responsible for two thirds of the eye’s focusing power.

It can be affected by numerous conditions which include inflammatory conditions, infections and disorders of shape.

Corneal conditions are diagnosed and treated by an Ophthalmologist who has undergone subspecialty training in this field.


Conditions associated

Some commonly seen corneal conditions include:

  • Keratitis (inflammation of the cornea)
  • Corneal abrasion (a scratch on the cornea occurring due to trauma or a weakness of the epithelium (the outermost skin of the cornea)
  • Corneal foreign body (a piece of debris embedding itself superficially on the surface of the cornea)
  • Corneal laceration (a partial or full thickness wound of the cornea as a result of trauma)
  • Keratoconus (a condition causing thinning and distortion of the cornea)
  • Corneal scarring (a gray-white mark left behind as a result of trauma or previous inflammation of the cornea)
  • Fuchs endothelial dystrophy: a corneal condition where the cornea becomes waterlogged as a result of poorly functioning endothelial cells.
  • Corneal dystrophies (inherited conditions causing gradual opacification of the cornea as a result of the metabolic by-products.

Symptoms

Symptoms experienced depend on the cause of the problem. These may include:

  • Pain
  • Redness
  • Light sensitivity
  • Doubling of vision
  • Hazy vision

Examination / Diagnosis

Abnormalities of the cornea and their subsequent diagnosis are dependent on the underlying problem.


Investigations needed

  • Slit lamp biomicrosopy: Corneal examination at the slit lamp by an Ophthalmologist.
  • Corneal topography – a surface map of the cornea used to diagnose keratoconus or astigmatism and evaluate suitability for vision correction procedures.
  • Anterior segment optical coherence tomography:  a high powered microscopic view of the cornea used to look at the corneal layers in greater detail.
  • Corneal pachymetry: an ultrasonic test used to determine the thickness of the cornea.
  • Specular microscopy / endothelial cell count: a high powered microscopic view of the inner layer (endothelium) of the cornea. This helps us determine the health of the cornea and whether or not an eye can tolerate surgery.

Treatment:

Treatment depends on the underlying condition.

Conditions & Treatment

Corneal Cross-Linking

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Corneal Transplant

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Keratoconus

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Meibomian Gland Dysfunction

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Investigations

Pentacam Topography

Combined device consisting of a slit illumination system and a Scheimpflug camera which rotates around the eye to give an automatic measurement of an over-all view of the anterior segment of the eye.

Sirius Topography

A non-contact measurement of the thickness of the nerve fibre layer.

Specular Microscope

Specular microscopy is a noninvasive photographic technique that allows you to visualise and analyse the size, shape and population of the endothelial cells.

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