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Cornea & External Disease

Blepharitis

Blepharitis is a chronic inflammation – a long-term swelling – of the eyelids and eyelash follicles. It may be caused by seborrheic dermatitis, acne, bacterial infection, allergic reaction or poor eyelid hygiene. They eyes may become red, blurry or tear frequently. The eyelids crust, flake, scale or redden, and the smooth inside lining of the lids may become rough. In more serious cases, sores can form when the crusting skin is removed, the eyelashes may fall out, the eyelids can deform, the infection can spread to the cornea, and patients often suffer from excessive tearing. Blepharitis can also cause styes, chalazions and problems with the tear film.

Treatment and preventative care for blepharitis involves thorough but gentle cleaning of the eyelids, face and scalp. Warm compresses can be applied to loosen crust and dandruff shampoo can help keep the eyelids clear. This may be combined with antibiotics if a bacterial infection is causing or contributing to the problems.

Corneal Transplantation for Corneal and External Eye Diseases

The cornea is the clear covering on the front of the eye which bends, or refracts, light rays that focus on the retina in the back of the eye. A certain shape or curvature is required in order for light to focus exactly on the retina, rather than in front of it or behind it.

An improperly curved cornea may be corrected surgically or non-invasively to reduce or eliminate the need for eyeglasses or contact lenses. A thorough eye examination and consultation are necessary before a treatment decision can be made.

Corneal transplantation, or keratoplasty, is recommended when the cornea's curvature is too steep or flat to be treated with other methods, or when extensive damage has occurred due to disease, infection or injury. Common problems that require transplantation are:

Dry Eyes
Blepharitis
Recurrent Erosion
Corneal Ulceration
Herpes Simplex Keratopathy
Pseudophakic Corneal Decompensation
Keratoconus

Corneal Dystrophies
Pterygia
External tumors
Eye infections
Traumatic injury
Ocular surface diseases
Chemical burn

Transplantation involves replacing the damaged cornea with a healthy one from a donor (usually through an eye bank). Keratoplasty is a low-risk procedure - it is the most common type of transplant surgery and has the highest success rate.

During the procedure, a circular incision is made in the cornea. A disc of tissue is removed and replaced with healthy tissue; these discs may be thin (lamellar keratoplasty) or as deep as the entire cornea (penetrating keratoplasty, the technique used in almost all corneal transplants). Local or general anesthesia may be used. The entire procedure lasts only 30-90 minutes.

DSAEK

DSAEK is the latest technique in corneal transplantation. Short for Descemet-stripping automated endothelial keratoplasty, DSAEK offers clear post-operative vision and short recovery time to patients in need of new corneas.

During the procedure, the surgeon makes a mark in the surface of the patient's cornea with a trephine (an instrument used to cut circular sections of tissue). That mark serves two purposes: it helps the surgeon determine what size the transplant should be, and it outlines the area of the patient's cornea that needs to be peeled away. Next, the surgeon scores the damaged section of the cornea and strips the membrane away from the eye. Then the donor cornea is folded into a "taco" shape and placed on the eye. A single stitch closes the incision.

Sometimes the new cornea unfolds on its own; other times, the surgeon unfolds it him/herself. When it is unfolded, a second stitch is made to close the wound and anchor the new cornea in place. The surgeon then injects an air bubble underneath the cornea, making sure it is centered on the eye, and dilates the pupil with eye drops.

Patients are sent to the recovery room for about one hour, after which they are examined at the slit lamp with the doctor. He or she gently presses on the cornea until most of the air bubble is released. Patients are then given antibiotics and steroid eye drops and will return the next day for a follow-up appointment.

Dry Eye

Dry eye occurs when the eyes aren't sufficiently moisturized, leading to itching, redness and pain from dry spots on the surface of the eye. The eyes may become dry and irritated because the tear ducts don't produce enough tears, or because the tears themselves have a chemical imbalance.

People usually begin experiencing dry eye symptoms as they age, but the condition can also result from certain medications, conditions or injuries.

Dry eye is not only painful, it can also damage the eye's tissues and impair vision. Fortunately, many treatment options are available.

Non-surgical treatments for dry eye include blinking exercises, increasing humidity at home or work, and use of artificial tears or moisturizing ointment. If these methods fail, small punctal plugs may be inserted in the corners of the eyes to limit tear drainage, or the drainage tubes in the eyes may be surgically closed. Eyelid surgery is also a solution if an eyelid condition is causing your dry eyes.

Dry Eye Disease Solutions

Excess Tearing/Watery Eyes

Although tears are necessary to lubricate the eyes and wash away foreign bodies and other particles, some people produce too many tears or cannot drain them properly, leading to excess tearing or watery eyes.

Tearing of the eyes can be caused by several different factors, including:

Allergies
Blepharitis
Blocked tear duct
Conjunctivitis
Dry eyes

Environmental irritants
Foreign bodies
Infection
Irritation
Trauma

Treatment for watery eyes depends on the underlying cause of the condition, but can often be treated at home. Artificial tears or anti-histamines may be recommended to treat dry eyes or allergies, while other causes may require antibiotics or even surgery to relieve symptoms.

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Cataracts

LASIK