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What are corneal conditions?

The cornea is the eye's outermost layer and acts as a window to the eye. It is made up of five delicate layers: the epithelium, bowman’s layer, stroma, descemet’s membrane and endothelium. The coloured iris and the pupil (the black dot in the centre of the iris) can be seen through the cornea.

The cornea helps to focus and transmit light as it is passed to the lens and on to the retina at the back of the eye. This ‘picture’ is in turn transmitted to the brain.

When the cornea is damaged it can lose its transparency or its shape can alter. This can prevent light from passing to the retina and causes the picture transmitted to the brain to be distorted or cloudy. When you can no longer see through it, a corneal transplant may be needed.

Corneal-related conditions may also be referred to as external eye diseases or ocular surface disease.

The cornea is a resilient part of the body and copes well with minor injuries and abrasions. However, there are many different types of diseases and disorders that could affect the cornea, a few of which are detailed below:

  • Corneal infection – After an injury to the cornea has occurred it may become contaminated, causing painful inflammation and infections which may reduce the clarity of your vision
  • Dry Eye - this refers to those who produce too few, or low quality, tears and can are therefore unable to consistently lubricate the eye surface, to maintain a healthy eye. Symptoms of this condition include a ‘scratchy’ or ‘sandy’ feeling, as if something is in the eye. The sufferer may also experience stinging or burning f the eye, with excess tearing followed by a very dry sensation. Sometimes, you may experience blurred or decreased vision, although loss of vision is uncommon.
  • Keratoconus – A degenerative disorder in which changes within the cornea cause it to thin and change into a more conical shape than normal. This involves a protrusion of the cornea that ultimately distorts vision in its sufferers.

Who is at risk?

As there is such a large range of corneal-related conditions that patients may suffer from, there is a large variety of demographics that may be affected.

Anyone is at risk of developing a corneal infection, as this may be due to an injury received. However, individuals who wear their contact lenses overnight are at most risk of developing an infection.

For instance, Dry Eye is more common in women, particularly after menopause, but may also affect those who:

  • Habitually take antihistamines, nasal decongestants or anti-depressants.
  • Suffer from connective tissue disorders, such as rheumatoid arthritis

Conversely, the risk of developing Keratoconus is higher if you have certain inherited diseases or genetic conditions, such as Down syndrome. However, individuals with allergies, asthma, connective tissue disorders and some retinal diseases may also develop this condition. It is typically diagnosed during adolescence.

It is important to stress that there are a vast number of different disorders relating to the cornea, and if you are experiencing any discomfort or distorted vision of any kind you should seek medical assistance from your GP.

How corneal conditions affect our vision

Different corneal disorders will affect vision in different ways.

Corneal infections may cause the patient mild or great pain. Eyes may also be sensitive to bright light, or vision may become blurry. These infections may also cause discomfort when opening or closing the eyelids.

If diagnosed in good time, dry eye will have limited affect on vision, and the patient will only suffer the uncomfortable symptoms. However, if left untreated there may be serious implications on vision, as the cornea may be perforated leading to infection and reduced visibility. Therefore, it is important to seek medical assistance as soon as symptoms materialise.

Keratoconus can cause substantial distortion of vision, and patients have reported multiple images, streaking and sensitivity to light. If both eyes are affected this may significantly reduce the patient’s ability to drive a car and many other daily activities.

These conditions may affect one or both eyes.

How corneal conditions are treated.

Minor corneal infections may be treated with anti-bacterial eye drops, but if symptoms worsen or the infection is more severe a consultant may prescribe antibiotic or steroid eye drops.

Artificial tears, which lubricate the eye, are the principal treatment for Dry Eye. These will usually come in the form of eye drops. For individuals suffering from more severe cases, a consultant may prescribe mild steroid eye drops, or a simple surgery may be required to alter the opening of the tear drain.

Patients suffering from Keratoconus may receive relief with the use of corrective glasses or rigid contact lenses. However, a corneal transplant may be necessary, as will it be for other severe corneal disorders.

It is important to stress that there are a vast number of different disorders relating to the cornea, and if you are experiencing any discomfort or distorted vision of any kind you should seek medical assistance from your GP. Your consultant will discuss any form of treatment with you at your initial consultation.

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