Cornea
ProblemsIntroduction: The
cornea is the front layer of the eyeball as is explained elsewhere ("anatomy
of the eye"). There are several eye diseases and other causes
that explain diseases of the cornea. For instance, when an iron piece gets imbedded
into the superficial layer of the cornea, which is a common injury in welders,
this sets up a traumatic conjunctivitis and the patient will have a lot of pain.
A virus can cause little cornea ulcerations as is the case with herpes zoster,
a dangerous corneal condition. Inadequate tear production can also lead to a painful
dry eye syndrome (=keratoconjunctivitis sicca). Vitamin A deficiency can lead
to a malnutrition state (called "keratomalacia") of the cornea where
it becomes vulnerable to ulcerations with secondary infections. Here is a brief
overview of these conditions and their symptoms. Signs and
Symptoms:
| Various
types of corneal problems |
| Name (diagnosis): | Symptoms
and/or causes: | | bullous
keratopathy | can occur
following cataract surgery, related to it is Fuchs'
endothelial dystrophy | | corneal
ulcer | various bacteria
and viruses can cause it, photophobia, tearing eyes, pain |
| herpes
simplex keratitis | herpes
simplex type I can affect the lips and the eyes, see the link for more info |
| herpes
zoster ophthalmicus | herpes
zoster eye infections can affect various structures of the eye (see links) |
| interstitial
keratitis | often
associated with uveitis, rare in the US, common in Africa. Syphilis common. |
| keratoconjunctivitis
sicca | associated
with Sjögren's syndrome and rheumatoid arthritis. Dry eyes, itchy, not enough
tear fluid. | | keratoconus | inherited
condition getting symptomatic at age 10 to 20. Conically shaped cornea. |
| keratomalacia | vitamin
A deficiency leads to corneal ulcerations as
explained here | | peripheral
ulcerative keratitis | often
found in rheumatoid arthritis patients. These patients do better when treated
with cytotoxic immunosuppression | | phlyctenular
keratoconjunctivitis | occurs
in children, seems to be an allergic reaction to an undefined antigen |
| superficial
punctated keratitis | a
variety of causes can bring on this condition, viral, UV light, contact lenses
etc. | | Top
of table |
Diagnostic
tests: Inspection by the eye specialist and slit
lamp examination are the main mode of diagnostic testing. This is
helped by bacterial swabs and viral studies, if indicated. Fluorescein
staining can help to see superficial defects in the cornea. The Schirmer
test shows whether there is enough tear fluid being produced. Treatment: Treatment
is specifically directed against the underlying cause. It is important to stress
here that self made home remedies have no place in eye diseases as the patient
does not know exactly what is going on. You need a knowledgeable eye specialist
who will pinpoint exactly what is going on. Then a treatment plan including regular
follow-up visits can be arranged to ensure that the condition gets cured or controlled
without permanent loss of vision. The links in the table on various
types of corneal problems contains much information regarding treatment
for the various conditions.
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