Corneal opacity is the clouding of cornea due to various pathologies. Black part of the eyes turns white partially or completely depending upon the severity of corneal opacity.
Cornea is a transparent layer of cornea, which appears black or brown depending upon the color if iris. Light passes through the cornea and help patients see. Any opacity or scarring can cause a decrease in vision.
Causes of Corneal Opacity
Corneal Infection or Corneal Ulcers
Corneal infections can be caused by bacteria, fungus or virus. They can cause corneal opacity or scaring. Despite of treatment of these infections they leave permanent corneal opacity, which affects the vision.
Corneal Dystrophy or Degeneration
There are various dystrophies and degenerations, which affects the cornea. These conditions are usually bilateral and progressive in nature. Many a times abnormal material gets deposited inside the corneal layers making the vision poor.
These conditions are usually painless but can cause significant symptoms later on:
- Genetic and run in families
- Both eyes get affected
- Some are more common in men and some in woman
Corneal dystrophy is divided upon the layer of cornea it affects:
- Anterior or Superficial Corneal Dystrophies
- Stromal corneal dystrophy
- Posterior Corneal Dystrophies
Symptoms of Corneal Dystrophies
- Sensitivity to light
- Blurring of the vision
- pain in the eye
- Foreign body sensation
- Corneal erosions
Early stages of the disease don’t require much of treatment. When these dystrophies affect patients vision significantly then corneal transplant is the treatment of choice.
Keratoconus is one of such disease in which the cornea becomes conical losing its round shape. The thickness of cornea decreases as keratoconus progresses. This condition is bilateral but asymmetrical. One eye get affected more than the other.
Keratoconus causes decrease in vision, distortion of vision, photophobia and increase in refractive errors. In advanced cases of keratoconus, cornea develops a scar leading to permanent decrease in vision.
Treatment of keratoconus
First of all, it is very important to assess if keratoconus is progressing or not. For this Pentacam HR test should be done. Based on the reports, if it is progressing then Collagen cross-linking should be done. In advanced cases of keratoconus where corneal scar is present, patient may require a corneal transplant.
Fuchs corneal dystrophy is another disease of cornea in which the inner layer of the cornea that is endothelium stops functioning properly. In this problem cornea becomes cloudy and vision deteriorates.
Treatment of this problem is endothelial corneal transplant. DSAEK and DMEK are the procedure of choice for Fuchs dystrophy.
Any object hitting the eye can cause trauma to the eye. Common causes of ocular trauma are:
- Chemical injury like Chuna, acid, paint, fevicol
- Dust and sand
- Injury by nail or finger
- Something striking the eye, such as a tree branch, leaf
- Sports injury with ball or shuttlecock
- Contact lens induced trauma
Corneal scarring due to trauma is usually permanent and does not improve with medicines. These patients also require a corneal transplant.
Stem Cell Deficiency
Stem cell deficiency is not very uncommon. This problem can affect the patient’s cornea and can cause the corneal scarring or opacity and results in deterioration in vision. Stem cell loss can be caused by chemical injury to the eye.
Corneal transplant is done in hospitals which have HOTA(human organ transplant act) permission. Only a trained cornea surgeon can do corneal transplant.
Symptoms of corneal damage may include:
- Redness and swelling of the eye tissues and eyelid
- Decrease in vision
- Sensitivity to light or photophobia
- Foreign body sensation
- Eye discharge
- White scar in cornea
- Complete loss of vision
Treatment of corneal opacity depends upon the severity, location, duration of opacity and other associated eye problem. A small opacity in the corneal periphery dosen’t interfere with the vision. Larger central corneal opacity can affect vision and in many cases require corneal transplant.
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