CORNEAL DISEASES & MANAGEMENT

Cornea is a clear glass like structure in front of the eye. Any disease affecting this structure results in loss of corneal clarity and thereby affecting vision. Corneal scarring can result from infections and trauma (mechanical, thermal or chemical). Abnormalities in corneal shape like keratoconus result from inherent structural abnormally and also affect vision.

Some of these conditions can be managed with semi soft contact lens wear. However some of these patients require surgical intervention. Besides conventional full thickness corneal transplantation, newer modalities of treatment such as Deep Anterior Lamellar Keratoplasty (DALK) are performed for better visual outcome. The host endothelial layer is retained; hence there is no risk of rejection unlike conventional corneal grafts.

The innermost layer of the corneal may become dysfunctional in certain conditions and result in clouding of the cornea. This usually requires full thickness corneal transplantation surgery to restore corneal clarity. Newer surgical techniques such as Deep Lamellar Endothelial Keratoplast (DLEK) allow surgical replacement of the corneal endothelium without any surface incisions or sutures.

Corneal scarring can also affect newborn children and often require early surgical intervention to prevent visual deprivation and loss of visual development.

Infections of the cornea are not uncommon and require immediate attention. Microbiological tests are necessary to identify the causative organism and initiate appropriate medical therapy. Surgical interventions may be necessary in cases with advances infections.

Ocular surface reconstruction is necessary in cases following chemical or thermal injury, extensive ocular surface tumors or infections.  Surface reconstruction is performed using amniotic membrane and limbal transplantation.