Corneal Diseases

Corneal Abrasion

The cornea is the clear front window of the eye. It covers the iris (the colored portion of the eye) and the round pupil. The cornea is composed of five layers. The outermost layer is called the epithelium.

Injuries to the epithelium, such as scratches, cuts, or scrapes, are known as corneal abrasions. Usually, these injuries are caused by fingernail scratches, makeup brushes, paper cuts, or rubbing of the eyes. Sometimes conditions like dry eye can cause abrasions. Symptoms associated with corneal abrasions include tearing, redness, pain, soreness, and blurred vision.

Abrasion:         



Treatment options for corneal abrasions include patching the injured eye, dilating pupils to relieve pain, wearing special contact lenses that promote healing, using topical antibiotics to prevent infection, and using lubricating ointments and eyedrops.  Minor abrasions usually heal within a day or two, while larger abrasions take about a week.

Corneal Erosion

Corneal erosions are caused by loose attachments of the epithelium to the underlying tissue. This often happens at the site of an earlier abrasion. Some patients have an underlying condition called œmap-dot-fingerprint dystrophy that predisposes them to having recurrent corneal erosions.  Symptoms of corneal erosion are similar to those of abrasions: pain, soreness, redness, and blurred vision.

Treatment is the same as for corneal abrasion and may also include saline solution eyedrops or ointments. However, if the erosion keeps occurring, further treatment may be necessary. These treatments may include procedures to remove the damaged epithelium, removal of corneal cells using a laser, or performing an anterior stromal micro-puncture, which involves making tiny holes on the surface of the cornea to promote stronger attachments between the top layer of corneal cells and the layer of the cornea underneath.

Corneal Ulcers

Corneal ulcers can form due to trauma, contact lens use, eyelid disease, severe dry eye, fungal infections, herpes simplex viral infections, and other causes.
There are two very common types of corneal ulcers. Bacterial ulcers tend to be the most painful type of corneal ulcer, and in some cases, if left untreated, can cause severe damage or even corneal perforation. Sterile ulcers, on the other hand, usually cause little or no pain.  Improper care and handling of contact lenses, which can lead to infection, are often causes of corneal ulcers.
The symptoms of corneal ulcers may include:

  • pain;
  • redness;
  • blurred vision;
  • tearing;
  • discharge; and
  • sensitivity to light.

Treatment for corneal ulcers depends on the cause. It usually includes steroid or anti-inflammatory eyedrops, and strong antibiotic eyedrops.  In rare cases when the cornea is severely damaged, a corneal transplant may be necessary to improve vision.

Small Corneal Ulcer:                  


Herpetic Keratitis (HSV Keratitis)

Herpetic keratitis is a viral infection of the eye caused by the herpes simplex virus, which is best known for causing cold sores. Herpes keratitis usually affects only one eye and most often occurs on the cornea, the normally clear dome that covers the front part of the eye.
The symptoms of herpes keratitis may include:

  • pain;
  • redness;
  • blurred vision;
  • tearing;
  • discharge; and
  • sensitivity to light.

If the infection is superficial, with ulcers involving only the cornea's top layer, called the epithelium, it will usually heal without scarring. However, if it involves the deeper layers of the cornea, it may lead to scarring of the cornea, loss of vision, and sometimes even blindness. Left untreated, herpes keratitis can severely damage your eye.

Herpetic Keratitis:     
 

Herpes keratitis is usually treated with antiviral medications, both in eyedrop and/or pill form. Depending on the progression of the infection, Dr. Haas may treat your condition with steroid eyedrops as well to reduce inflammation. Rarely, when the cornea is severely damaged, a corneal transplant may be necessary to improve vision.