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Cornea

What is the cornea?

The cornea is the clear dome-shaped tissue on the front of the eye. It protects the eye from germs and debris while providing a clear path for light to enter the eye and focus on the retina. It consists of five discreet layers including the epithelium, Bowman’s layer, stroma, Descemet’s membrane, and endothelium.

Structure of the Cornea

What is a cornea transplant?

A cornea transplant involves taking healthy tissue from a donor and using it to replace diseased or damaged tissue in a patient’s eye. There are various types of corneal transplants depending on what portions of the cornea need to be replaced. The most common include: penetrating keratoplasty (PKP), Descemet’s stripping automated endothelial keratoplasty (DSAEK), and Descemet’s membrane endothelial keratoplasty (DMEK).

More cornea questions and answers:

What is a penetrating keratoplasty?

A penetrating keratoplasty (PKP) is where all layers of the cornea are replaced. This surgery has the advantage of being able to repair significant damage that has been done to the cornea but has a longer recovery than other transplants and corrective glasses or special contact lenses are usually needed to provide a patient with the best possible vision.

What is a Descemet's stripping automated endothelial keratoplasty?

A Descemet’s stripping automated endothelial keratoplasty (DSAEK) is a partial thickness corneal transplant aimed at replacing damaged or poorly functioning endothelial cells. These cells function as pumps that keep the cornea optically clear so their dysfunction usually leads to a cloudy cornea. The DSAEK can be done with only small incisions to the cornea and has a much faster rate of recovery and better potential vision after surgery than a PKP. A DSAEK graft consists of endothelial cells with a portion of the center of the cornea called the stroma. While new techniques like DMEK have advantages over DSAEK, it is still an excellent surgical option for eyes that have other problems like glaucoma or a history of retinal detachments.

What is a Descemet's membrane endothelial keratoplasty?

A Descemet’s membrane endothelial keratoplasty (DMEK) represents the latest in corneal transplant technique and technology. Like DSAEK, DMEK is a partial thickness corneal transplant whose goal is to replace dysfunctional endothelial cells. A DMEK graft is only a few microns thick and involves no excess tissue. This leads to faster visual recovery and improved visual potential.

What is Fuchs’ Dystrophy?

Diagnostic image of a close up of an eye showing the effects of Fuchs DystrophyFuchs’ dystrophy is a disease of endothelial dysfunction that usually occurs in older adults. It can be sporadic or run in families. Endothelial cells function as pumps to keep the cornea optically clear. When these pumps stop working properly, the cornea can become cloudy. This causes blurred vision and in advanced cases the cloudy cornea can begin to break down and lead to painful blisters called bullae. Fuchs’ dystrophy can be surgically corrected with partial thickness cornea transplants like DSAEK and DMEK.

What is a pterygium?

 

A pterygium is a noncancerous growth of tissue onto the cornea. It originates from the conjunctiva (clear layer of tissue covering the white of the eye) and is associated with sun exposure. A pterygium can cause irritation, redness, and decreased vision as it moves towards the center of the cornea. It can be surgically removed to fix these concerning symptoms and provide better cosmetic appearance.

Eye with Pterygium
Eye with Pterygium

What is a corneal abrasion?

When someone says they’ve scratched their eye, they likely have a corneal abrasion. A corneal abrasion is where the top layer of cell protecting the eye, called the epithelium, is removed. Due to the high number of nerves in the cornea, this can be extremely painful and lead to infection and scarring if the wound becomes infected. If properly treated, corneal abrasion usually heals within a few days.

What is a corneal ulcer?

A corneal ulcer is an infection of the deeper layers of the cornea. It can be caused by bacteria, viruses, fungus and even some parasites. These infections are very serious and can be potentially blinding if not treated appropriately. Sleeping in contacts increases your risk of a corneal ulcers by 6 to 8 times!

Can I get shingles in my eye?

The shingles virus (also known as varicella zoster virus or VZV) is the same virus that causes chickenpox. Once we are infected by chickenpox, the virus forever lives in certain nerves of our body. Occasionally, this virus can reactivate causing a painful blistering rash called shingles. The virus can even appear in the eyes causing nerves damage, painful ulceration, and permanent scarring. It is important to have your eyes examined if you have shingles on your face or forehead to ensure that there is no ocular involvement.

What is anterior basement membrane dystrophy?

Diagnostic image of a close up of an eye showing the effects of anterior basement membrane dystrophyAnterior basement membrane dystrophy (ABMD) is a disease where the top layer of cells on the cornea called epithelium does not adhere to the rest of the cornea properly. This can lead to painful epithelial erosions caused by the tissue sloughing off or being torn. These erosions usually occur during the night or in the morning when the eyes become dry and the eyelid sticks to this fragile tissue. Fortunately, there are multiple medical and surgical treatment options to improve and often resolve this condition.

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