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What is the cornea?
The cornea is the outermost layer of the eye, which is clear and dome-shaped. The black part of the eye, the iris, if you observe, is covered by the transparent, dome-shaped cornea. The cornea, along with the natural lens of the eye is responsible for focusing the rays of light entering the eye, on to the retina, the light-sensitive portion of the eye.
For the cornea to function correctly, it must remain transparent and free from any surface irregularities. In scarring, which can be due to infections, inflammations, trauma, or hereditary diseases of the cornea, can result in severe loss of vision and even corneal blindness.
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KERATOCONUS
Keratoconus is a condition that affects the cornea, causing it to thin and bulge into a cone shape. This can lead to distorted vision, sensitivity to light, and difficulty wearing contact lenses. While the cause of keratoconus is not fully understood, treatments such as corneal cross-linking and specialized contact lenses can help manage the condition and improve vision.
If keratoconus left untreated can result in severe corneal thinning, bulging and scarring of the cornea (corneal hydrops) making the patient blind. The scarred cornea would eventually require a corneal transplant procedure.
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TREATMENT
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COLLAGEN CROSS LINKING WITH RIBOFLAVIN (C3-R) TREATMENT :
It is non-invasive treatment for keratoconus. It strengthens the collagen tissue, which forms the fabric of the cornea thereby stopping it from bulging outwards and arresting keratoconus progression. In severe cases, C3-R treatment can also be combined with Intacs to achieve more flattening the Keratoconus cone.
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INTACS
Intacs are used to regularize the shape of the cornea. After the above procedures of intacs and C3R specialized contact lenses or implantable contact lenses can be given to achieve full visual potential.
INTACS MADE MORE EASIER,SAFER,AND ACCURATE WHEN DONE BY FEMTOSECOND LASER.
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KERATOPLASTY (CORNEAL TRANSPLANTATION) :
It is the option when not all the above methods help patients to get optimum useful vision. In this procedure the cornea, which forms the transparent outer covering of the eye, is replaced by a donor cornea. It is an intraocular surgery and requires long-term and consistent follow-up.
Keratoconus is a disease that causes a progressive thinning of the cornea (the clear front portion of the eye). As a result of this condition, the normal outward pressure from within the eye causes the cornea to progressively bulge into a cone-like shape.
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PTERYGIUM
Pterygium is a veil like lesion that usually occurs in exposed part of white of the eye. This grows slowly over the cornea (the central black portion) and can obstruct vision or deteriorate vision by inducing cylindrical power.
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Symptoms of pterygium may include:
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Burning
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Gritty feeling
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Itching
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Sensation of a foreign body in the eye
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Blurred vision
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Causes of Pterygium : significant risk factors include:
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Prolonged exposure to ultraviolet light
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Dry eye
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Irritants such as dust and wind
Treatment of Pterygium
Pterygium is not only cosmetically disfiguring but can affect the vision also. In view of this it is advisable to surgically excise it at the earliest. Surgical excision of pterygium is a simple day care procedure with no adverse effects.
Latest surgery method involves removing the pterygium tissue and placing a healthy tissue on bare area which prevents recurrence and is cosmetically very rewarding.
Surgery for pterygium is minimally invasive, sutureless and is very safe.
Pterygium does not respond to medical treatment of any kind be it in form of eye drops or ointment and surgical excision is the treatment of choice
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CORNEAL BLINDNESS
Any profound decrease in vision or blindness due to diseases of the cornea is termed corneal blindness. It is the 4th most common cause of blindness all over the world, accounting for over 5% of the total blind population. The other leading causes include cataract, glaucoma, and age-related macular degeneration.
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What are the causes of corneal blindness?
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Infections and Ulcerations: Bacterial, fungal, or viral keratitis or infection of the cornea
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Malnutrition: Vitamin A deficiency is also an important reason for childhood blindness
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Trauma: Eye trauma and corneal ulcerations are the second most important disease burden
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Congenital Diseases: Also, each year 3.5 Lakh children are affected by blindness, either due to
a congenital disorder (born blind) or due to corneal infections and ulcerations in early infancy.
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Other Corneal Disorders: Certain hereditary and acquired disorders like Fuch’s Endothelial
Dystrophy, Pseudophakic bullous Keratopathy, and other corneal degenerations and dystrophies can also cause a profound loss of vision.
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Lifestyle Issues: Traditional medicine or home remedies, is the fact that several ayurvedic drops which may cause more harm than good, resulting in loss of vision. Practices of using honey, certain oils, plant juices as an eye drop for eye cleansing are potentially disastrous and dispensing of steroid eye drops by chemists and quacks.
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What is the definitive cure?
Definitive treatment of corneal blindness is corneal transplantation or corneal graft. In this
surgery, either part or the entire cornea is replaced by one which has been donated upon
death by another person. The reason for the large number of people still awaiting corneal
transplants is that the number of eyes donated each year are far less than those required for
the existing people with corneal blindness. Also, fresh cases of corneal blindness keep getting
added, swelling the numbers on the transplant list
The most important directive for decreasing corneal blindness, therefore, is two-fold: promoting
eye donation and transplantation, while at the same time, preventing corneal blindness by
improving awareness about eye diseases and promoting timely interventions.
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