The 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.
Infections of the cornea require microbiological testing and intensive topical antimicrobial therapy (as the cornea is AVASCULAR and effects of tablets does not reach the cornea properly).
This is one of the Emergency situations in Ophthalmology.
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 patient’s needs which comprise of MMP9 diagnostic test and other dry eye evaluation methods.
Based on the workup results,the treatment is further bifurcated into medical management with the help of eye drops, punctual plug occlusion treatment
If medical management is 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).
Quest for the “ideal”substance continues.But meanwhile,the following options are available for pts who are unsuitable for Keratoplasty/who have failed transplants.
Options are:
Keartoprosthesis – Boston’s
OOKP- Osteo-odonto KP
Many corneal disorders are due to LSCD.Limbal stem cells Healthy can be harvested from the healthy eye of family members and transplanted on to the defective cornea.The following types are done:Direct & Cultivated
These surgeries help in ocular surface reconstructive which in itself may lead to visual rehabilitation/may require to be coupled with corneal transplantation.
