Corneal Diseases

Dry eye syndrome (keratitis sicca)

Severe dry eyes as a result of dry spots on the cornea

Recurrent corneal erosion

The epithelium is the outmost layer of the cornea. Usually this layer is firmly attached to the underlying stroma. The epithelium, however, can detach or be damaged by a superficial trauma to the eye, for example by a twig, a fingernail, a piece of paper... In this case, we are talking about corneal erosion. It is often extremely painful. Patients consult their ophthalmologist because they can barely keep their eye open. The eye is tearing and the vision is murky.

The epithelium usually repairs itself quite quickly, but sometimes the healing is irregular, leading to the epithelium detaching again. In this case we are talking about recurrent erosion.

Sometimes the epithelium is disfigured. Here we are dealing with a map-dot-fingerprint dystrophy. Occasionally people with map-dot-fingerprint dystrophy will have spontaneous erosion. This means that they have not had any kind of history of trauma and yet they have recurrent erosion or abrasions on their cornea.

People with recurrent erosion are always treated firstly with hydrating eye drops and ointments. Sometimes an eye patch will be applied. In other cases, it is necessary to place a bandage contact lens on the eye.

If these methods are not sufficient and patients are having a lot of discomfort from recurring and painful abrasions on the cornea, then the opthamologist could suggest Phytotherapeutic Keratectomy or PTK as a possible solution.

Fuchs enthothelial dystrophy or cornea guttata is the most common disease of the endothelium in the eye. The endothelium is exactly one cell layer thick. It is constantly pumping water out of the stroma so that the cornea remains thin and transparent. In the case of Fuchs endothelial dystrophy, this endothelial layer is compromised. Due to this pump not working sufficiently, the cornea swells and becomes less clear.

Patients with Fuchs dystrophy often complain about cloudy vision. In most cases a posterior lamellar corneal transplant or DSAEK can restore proper vision.

Keratoconus is a disorder of the eye that usually begins during childhood but which only starts disrupting vision around the age of 20 or 30. In patients with keratoconus, the shape of the cornea is progressively changing. The cornea appears to stick out. Patients consult their ophthamologist due to distorted vision or decreasing sight.

In most cases, wearing semi-rigid contact lenses will improve vision. Sometimes a corneal transplant is necessary. Lasering the eye by means of cross linking can potentially help stiffen the cornea so that the condition does not get worse. Keratoconus is a disease which almost always affects both eyes, but asymmetrically. Keratoconus affects approximately 1 in 1500 people. This disease cannot be cured.