Cornea is the transparent Watch-glass-like structure in front of the eye. It has six layers as follows: Epithelium, Bowman’s membrane, Stroma, DUA’S MEMBRANE-NEW Layer discovered recently, Descemet’s membrane, Endothelium.
Cornea is the first refractive Surface through which light passes into the eye. Any abnormality in its shape/ structure or clarity can affect vision.
Cornea is prone to external injuries which can directly adversely affect the vision hence early and urgent intervention in corneal diseases is also of prime importance.
Following are the treatment modalities which are applicable for treatment of corneal disorders
A) Medication in Cornea:
- Infections of the cornea require microbiological testing and intensive topical antimicrobial therapy (as cornea is AVASCULAR and effects of tablets does not reach the cornea properly).
- This is one of the Emergency situations in Ophthalmology.
B) Dry Eye and Computer Vision Clinic
- Dryness due to constant exposure to computer and mobile screens and other lifestyle altering situations, dryness secondary to many untreated eye diseases now comprises of mainstream diagnosis and treatment
- We have Major and Mini dry eye workup suitable to the patients needs which comprises of MMP9 diagnostic test and other dry eye evaluation methods.
- Based on the workup results, the treatment is further bifurcated into medical management with help of eye drops, punctal plug occlusion treatment.
C) Surgeries of cornea:
- If medical management successful, cornea heals with scarring and may still require surgery (transplant) for visual rehabilitation (optical Keratoplasty). This can be,
- Full thickness (Penetrating Keratoplasty)
- Partial (lamellar) (ALK/DSEK)
- If medical management fails, then emergency corneal transplant may also be required (Therapeutic Penetrating Keratoplasty) for removing infected tissue and saving the eye in the first place. Further, visual rehabilitation is considered later. (After 3 months).
D) Artificial Cornea.
- Quest for the “ideal” substance continues. But meanwhile following options are available for pts who are unsuitable for Keratoplasty / who have failed transplants. Options are:
- Keartoprosthesis – Boston’s
- OOKP- Osteo-odonto KP
E) Contact Lens- is fitted over the cornea and can be of different varieties:
- Soft contact lens
- RGP CC
- Specialty Scleral contact lens – Rose K contact lens
F) LIMBAL STEM CELL THERAPY TRANSPLANTATION
- Many corneal disorders are due to LSCD. Limbal stem cells Healthy can be harvested from healthy eye of family members and transplanted on to defective cornea. The following types are done:
- These surgeries help in ocular surface reconstructive which in itself may lead to visual rehabilitation/may require to be coupled with corneal transplantation.