Cornea and keratoconus
The cornea is the clear window at the front of the eye. When it is infected, scarred, thinned or injured, it can often be repaired, and sometimes replaced.
The cornea does most of the eye's focusing, so a small problem shows quickly.
Keratoconus can be halted by cross-linking, if it is found early.
A scarred cornea can be replaced by transplant.
Why the cornea matters
The cornea is clear, curved and only about half a millimetre thick, and it does about two thirds of the eye's focusing. Anything that clouds, roughens or reshapes it blurs your sight, and the first days of an infection or an injury often decide how much sight is kept.
Keratoconus
In keratoconus the cornea slowly thins and bulges into a cone. It usually begins in the teens or twenties, and glasses stop sharpening the picture. Allergy and rubbing the eyes make it worse.
A corneal map finds it early. Corneal cross-linking, in which riboflavin drops and ultraviolet light strengthen the cornea, can then stop it getting worse.
Infections, ulcers and injuries
Netralaya treats corneal infections and ulcers, dystrophies, and injuries including burns and firecracker injuries. Surface disease can be treated with an amniotic membrane graft, and pterygium, a growth across the cornea, is removed with a conjunctival autograft.
Do not wait. A chemical splash, a firecracker injury or a sharp object in the eye is an emergency. Do not rub the eye. For a chemical, rinse with plenty of clean water for at least fifteen minutes first, then come straight away.
Corneal transplant
When a cornea is scarred beyond repair it can be replaced. A full-thickness transplant replaces all of it. A lamellar transplant replaces only the diseased layers and keeps the healthy ones.
Full thickness
The whole cornea is replaced, when every layer is affected.
Lamellar
Only the diseased layers are replaced, which can mean a quicker, gentler recovery.
Keep reading.
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Quick answers.
Can keratoconus be cured?
Cross-linking can stop it getting worse, and special lenses or, later, a transplant can restore useful sight. It cannot be reversed, so finding it early matters.
Will I need a transplant?
Most people with keratoconus never do, if it is caught early and cross-linked. A transplant is for corneas scarred beyond repair.
How can I protect my corneas?
Do not rub your eyes, treat allergies, never sleep in contact lenses, and see a doctor the same day for a red, painful eye.
Pictures not taken by the hospital: Tony Litvyak, Unsplash.