The Window Through Which You See

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The Window Through Which You See

The cornea is the front surface of the eye, and is typically completely clear in healthy patients. In addition to providing a barrier to the inside of the eye, the cornea is extremely important for vision. In healthy patients, the cornea helps focus the light entering the eye, and helps provide clear passage of light into the eye. When the cornea is sick, a patient may experience severe pain and/or loss of vision. There are a number of problems that can affect the cornea, including infection, inflammation, swelling, post-surgical problems, and even problems that patients may have been born with, or developed from a genetic condition. Treatment of corneal disease depends on the underlying cause, but can include antibiotic drops, other medicated drops, minor procedures, or more major surgery, to include corneal transplantation.

Corneal abrasions are scratches of the cornea, commonly caused by fingernails or outdoor foliage. Corneal abrasions can be surprisingly painful, and can cause decreased vision as well. It is important that patients with corneal abrasions get treated with antibiotic drops or ointment to help prevent corneal infections.

Corneal infections (known medically as corneal ulcers) can be caused by bacteria, viruses, or in rare cases, fungi. These corneal ulcers are most commonly treated with antibiotic eye drops, and in some cases may even require oral medications. Prognosis in these cases often depends on the severity of the initial infection, and the cause of the infection.

A pterygium is a non-cancerous growth on the surface of the cornea, that is thought to be related to long-term UV light exposure. Treatment of small pterygia is typically medical, with eye drops as a mainstay of therapy. Larger and more severe pterygia are treated with surgery.

Unfortunately, the surface of the eye can also have pre-cancerous or cancerous growths, similar to skin cancer. These ocular surface tumors are treated with chemotherapy and with surgery. Sometimes the ophthalmologist will enlist the assistance of an oncologist or ocular oncologist in more severe or concerning cases.

Swelling of the cornea sometimes occurs after eye surgery, sometimes occurs secondary to an underlying eye condition (such as Fuchs’ dystrophy), and often is caused by a combination of both. If the corneal swelling is mild, it may be effectively treated with eye drops. However, if it is more severe, it may require a corneal transplant. Keratoconus is another common eye condition that may require corneal transplantation in its more severe forms. There are two basic types of corneal transplants, partial thickness transplants and full thickness transplants. The type of surgery is chosen by the cornea specialist, depending on the disease that the patient has.

If your optometrist or primary care doctor suspect a corneal problem, a fellowship trained cornea specialist is the ophthalmologist you want to see.