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Diseases and Disorders of the Cornea

Diseases and Disorders of the Cornea

ALLERGIC CONJUNCTIVITIS

Allergies - Allergies affecting the eye are fairly common.
Common in children
The most common allergies are those related to pollen, particularly when the weather is warm and dry.

Symptoms can include redness, itching, tearing, burning, stinging, and watery discharge, although they are not usually severe enough to require medical attention Environmental change in weather helps the symptoms such as rain and cooler weather, which decreases the amount of pollen in the air.

Treatment.

  1. Cold water compresses
  2. Antihistamine decongestant, Mast cell stabilizer eyedrops can effectively reduce these symptoms,
  3. Low potent steroids

Conjunctivitis Conjunctivitis

An increasing number of eye allergy cases are related to medications and contact lens wear. Also, animal hair and certain cosmetics, such as mascara, face creams, and eyebrow pencil, can cause allergies that affect the eye. Touching or rubbing eyes after handling nail polish, soaps, or chemicals may cause an allergic reaction.
Allergy symptoms are temporary and can eliminated by not having contact with the offending cosmetic or detergent.

Conjunctivitis (PINK EYE)

This term describes a group of diseases that cause swelling, itching, burning, and redness of the conjunctiva, the protective membrane that lines the eyelids and covers exposed areas of the sclera, or white of the eye.


At its onset, conjunctivitis is usually painless and does not adversely affect vision. The infection will clear in most cases without requiring medical care. But for some forms of conjunctivitis, treatment will be needed. If treatment is delayed, the infection may worsen and cause corneal inflammation and a decrease invision.

 

  1. Infective- Bacterial, Viral, Contact lens induced, Environmental Irritants
  2. Non Infective-Allergic

 

Conjunctivitis
Conjunctivitis

 

Symptoms: swelling, itching, burning and redness of the conjunctiva.

 

Conjunctivitis
  • Can be bacterial or viral
  • Spreads from one person to the other
  • Acute- less than 4 weeks -Subacute & chronic-more than 4 weeks
  • Requires antibiotic drops, lubricating drops, cold water compresses

Corneal Ulcer

 

corneal ulcer

 

a) Damage caused to the cornea due to injury i.e foreign body penetrating the corneal tissue , Vegatative matter like leaf , injury during welding ,organism entering through contaminated contact lens or lens solution .


Symptoms: Pain, discharge ,Decrease in the vision

 

As a general rule, the deeper the corneal infection, the more severe the symptoms and complications. It should be noted that corneal infections, although relatively infrequent, are the most serious complication of contact lens wear

 

b) Organism affecting cornea may be bacterial, fungal, parasitic

 

c) Treatment

  • Medical : treatment in most cases based on the organism causing the ulcer could be Antibiotic or antifungal drops
  • Frequent visits to an eye care professional may be necessary for several months to eliminate the problem
  • Surgical : Corneal Transplant in refractory cases

 

Dry Eye

Continuous production and drainage of tears is important to the eye's health. Tears keep the eye moist, help wounds heal, and protect against eye infection.



In people with dry eye
  • The eye produces fewer or less quality tears
  • Or the tears evaporate fast thus unable to keep its surface lubricated and comfortable.
Dry Eye

 

Constituents of Tear film

Constituents of Tear film

The tear film consists of three layers—

  • an outer, oily (lipid) layer that keeps tears from evaporating too quickly and helps tears remain on the eye;
  • a middle (aqueous) layer that nourishes the cornea and conjunctiva;
  • and a bottom (mucin) layer that helps to spread the aqueous layer across the eye to ensure that the eye remains wet. As we age, the eyes usually produce fewer tears. Also, in some cases, the lipid and mucin layers produced by the eye are of such poor quality that tears cannot remain in the eye long enough to keep the eye sufficiently lubricated.

 

Symptoms

  • sandy feeling as if something is in the eye
  • stinging or burning of the eye
  • episodes of excess tearing that follow periods of very dry sensation
  • a stringy discharge from the eye; and pain and redness of the eye.
  • Sometimes people with dry eye experience heaviness of the eyelids or blurred, changing, or decreased vision, although loss of vision is uncommon.

 

Dry eye is more common in women, especially after menopause. Surprisingly, some people with dry eye may have tears that run down their cheeks. This is because the eye may be producing less of the lipid and mucin layers of the tear film, which help keep tears in the eye. When this happens, tears do not stay in the eye long enough to thoroughly moisten it.

symptoms

 

 

Factors Aggravating Dry Eye
  • • Environmental Stresses
    -Low Humidity: Air Conditioners, Central Heating
    -Pollution
  • • Computer Vision Syndrome
  • • Contact Lens Wear
  • • Various Disease States
  • • Ocular Surgery
  • • Medications
  • • Ageing
  • • Menopause

 


  • Visual Tasking
    (e.g. PC use)

  • Systemic Medications
    (e.g anti-histamines)

  • Food/Drink
    (e.g alochol)

  • Arid Conditions
    (e.g Midwes)

  • Whindy Environments
    (e.g air Conditioning, forced heat)

  • Pollutants
    (e.g exhaust, smoke)


People with connective tissue diseases, such as rheumatoid arthritis, can also develop dry eye. It is important to note that dry eye is sometimes a symptom of Sjögren's syndrome, a disease that attacks the body's lubricating glands, such as the tear and salivary glands. A complete physical examination may diagnose any underlying diseases.

 



Treatment

  • Artificial tears, which lubricate the eye, are the principal treatment for dry eye.
  • Sterile ointments are sometimes used at night to help prevent the eye from drying.
  • Disease modifying , immunomodulating eye drops,Secretogogues.
  • Using humidifiers, wearing wrap-around glasses when outside, and avoiding outside windy and dry conditions may bring relief.
  • For people with severe cases of dry eye, temporary or permanent closure of the tear drain (small openings at the inner corner of the eyelids where tears drain from the eye) may be helpful.

 

treating the cause and the effect

Corneal Dystrophies

A corneal dystrophy is a condition in which one or more parts of the cornea lose their normal clarity due to a build up of cloudy material. There are over 20 corneal dystrophies that affect all parts of the cornea.

 

These diseases share many traits:
  • They are usually inherited.
  • They affect the right and left eyes equally.
  • They are not caused by outside factors, such as injury or diet.
  • Most progress gradually.
  • Most usually begin in one of the five corneal layers and may later spread to nearby layers.
  • Most do not affect other parts of the body, nor are they related to diseases affecting other parts of the eye or body.
  • Most can occur in otherwise totally healthy people, male or female.
Corneal Dystrophies

 

Symptoms:
Corneal dystrophies affect vision in widely differing ways. Some cause severe visual impairment, while a few cause no vision problems and are discovered during a routine eye examination. Other dystrophies may cause repeated episodes of pain without leading to permanent loss of vision. Some of the most common corneal dystrophies include Fuchs' dystrophy, keratoconus, lattice dystrophy, and map-dot-fingerprint dystrophy.


Treatment:
Asymptomatic dystrophies need no treatment Corneal transplant for vision in symptomatic patients..