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Corneal Disease

The cornea is the eye's outermost coating. It is the clear, and dome-shaped surface that covers the front of the eye. Unlike most tissues in the body, the cornea contains no blood vessels to nourish or protect it against infection. The cornea must remain transparent to refract light correctly, and the presence of even the tiniest blood vessels can interfere with this process. In order to see well, all layers of the cornea must be free of any cloudy or opaque areas. The cornea is made up of five layers: Epithelium, Bowman's Layer, Stroma, Descemet's Membrane, and Endothelium.

Corneal Infections
On occasion the cornea is damaged after a foreign object has penetrated the tissue, such as from a poke in the eye. Other times, bacteria or fungi from a contaminated contact lens can pass into the cornea. Scenarios like theses can often cause painful inflammation and corneal infections called keratitis. These infections can reduce visual clarity, produce corneal discharges, and cause cornea erosion. Corneal infections can also lead to corneal scarring, which can impair vision and may require a corneal transplant.

The deeper the corneal infection, the more severe the symptoms and complications. It should be noted that corneal infections, although relatively infrequent, are the most serious complication of contact lens wear. Minor corneal infections are commonly treated with anti-bacterial eye drops. If the problem is severe, it may require more intensive antibiotic or anti-fungal treatment to eliminate the infection, as well as steroid eye drops to reduce inflammation. Frequent visits to an eye care professional may be necessary for several months to eliminate the problem.

Corneal Dystrophies
A corneal dystrophy is a condition where one or more parts of the cornea lose their normal clarity due to a buildup of cloudy material. There are over 20 corneal dystrophies that affect all parts of the cornea. These diseases share many characteristics:

• Are usually inherited.
• Affect the right and left eyes equally.
• Are not caused by outside factors, such as injury or diet.
• Most progress gradually.
• Begin in one of the five corneal layers and may later spread to nearby layers.
• Most do not affect other parts of the body, nor are they related to diseases affecting other parts of the eye or body.
• Most can occur in otherwise totally healthy people, male or female.

Corneal dystrophies affect vision in various ways. Some cause severe visual impairment, while a few cause no vision problems and are discovered during a routine eye examination. Other dystrophies may cause repeated episodes of pain without leading to permanent loss of vision. Some of the most common corneal dystrophies include Fuchs' dystrophy, keratoconus, lattice dystrophy, and map-dot-fingerprint dystrophy.

Keratoconus
This disorder causes a progressive thinning of the cornea and is the most common corneal dystrophy in the United States. It affects 1 in every 2000 Americans. It is more common in teenagers and adults in there 20s. Keratoconus arises when the middle of the cornea thins and gradually bulges outward, forming a rounded cone shape. This abnormal curvature changes the cornea's refractive power, producing moderate to severe distortion (astigmatism) and blurriness (nearsightedness) of vision. Keratoconus may also cause swelling and a sight impairing scarring of the tissue.

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