Corneal opacity
Introduction - corneal opacity
Corneal edema (corneal swelling) is caused by damage to the pump cells on the back surface of the cornea (Cornea - endothelial cells), causing fluid to penetrate the cornea.
This then leads to a thickening and clouding of the cornea, combined with a corresponding reduction in vision.
In the advanced stages of corneal edema, small vesicles on the surface of the cornea can burst, which can lead to pain, sensitivity to light and an increased risk of infection from bacterial corneal ulcers.
Detecting corneal opacity
What are the symptoms of corneal opacity?
Especially when the corneal opacities are in the center of the cornea, they can lead to blurred or blurred vision. This reduces vision and sometimes the picture appears distorted.
How is corneal opacification diagnosed?
An examination to precisely determine the corneal disease is carried out using anamnesis (questioning the patient), an eye test and an enlarged view of the eye.
Treating corneal opacity
How is corneal opacification treated?
In many cases, corneal opacities and scars on the cornea cannot be removed with conservative therapy, so that long-term treatment will result in a transplantation of a donor cornea.
Donor corneas are assigned via so-called corneal banks.
In the case of long-term corneal transplants, long waiting times can arise in the case of an emergency operation (Keratoplasty à chaud), however, the waiting list is bypassed in order to be able to preserve the eye.
The donated organ preparations come from deceased people who agreed to the transplant during their lifetime.
The corneas are examined for diseases before the operation and pretreated for an operation.
The corneal transplant (perforating keratoplasty) is given under local anesthesia with eye drops or by injection behind or next to the eyeball (Retro or parabular anesthesia) or performed under general anesthesia.
While looking through the surgical microscope, the patient's cornea is separated out before the appropriately cut donor cornea is attached with sutures.
The thread material is then usually removed after a year.
After the operation, anti-inflammatory and antibiotic drops or eye ointments are used.
Can the laser help?
In most cases where the disease is very advanced, a corneal transplant is the only way to prevent impending blindness.
However, if the disease is diagnosed at an early stage and only superficial layers of the cornea are scarred, therapy with the laser can be useful.
- In the so-called "phototherapeutic keratectomy (PTK)", the scarred layers are heated and removed by local laser application. By removing the affected layers, the cloudiness can be reduced.
You might also be interested in the following articles:
- Laser therapy for astigmatism
- Laser therapy for myopia
- Laser therapy for farsightedness
homeopathy
In most cases, corneal opacities can only be removed with laser therapy or surgical treatment.
In rare cases it can be useful to treat symptoms using homeopathy. However, homeopathy should always only be a complementary method to surgical therapy.
- Medicines such as eyebright (euphrasia) can counteract irritation or inflammation.
- Means such as Apis mellifica or Graphites can help prevent corneal opacity. However, an application should always be discussed with the attending physician.
Read more in the following articles: Homeopathy, Homeopathic Medicines
What are the causes of corneal opacity?
The most common causes of corneal opacity are swelling (Edema) or scars on the cornea.
Corneal scars can often be seen as white opacities on the eye.
They can occur after deep corneal injuries, deep corneal inflammation (mostly due to herpes viruses), after corneal ulcers, with advanced keratoconus or in rare cases as a hereditary metabolic disorder (corneal stromal dystrophy) occur.
Read more on the topic: Corneal dystrophy
Corneal opacity after cataract surgery
A cataract (cataract) is a clouding of the lens of the eye, which leads to a decrease in visual acuity. The most effective treatment for cataracts is surgery, in which the lens is removed and replaced with an artificial lens.
As a rule, cataract operations are associated with low risks, but rarely it can include the cornea becomes cloudy. Injuries during surgery, inflammation or mechanical influences can cause scarring and clouding of the corneal layers. In most cases, however, these go back on their own.
Also read: Cataract surgery
Corneal opacity from contact lenses
Contact lens wearers belong to the risk group for the appearance of corneal opacities. The constant mechanical manipulation of the cornea through the contact lens can lead to scarred changes.
In addition, contact lens wearers have an increased risk of inflammation in the corneal area, especially if they are poorly hygienic and change lenses too rarely. The inflammation can also promote the appearance of corneal opacities. Therefore, contact lens wearers should have regular ophthalmological checks.
Also read: Side effects of contact lenses
Course of corneal opacity
What is the expected course of corneal opacity?
Corneal opacities are usually recognized very late by the patient, which is why they are often only diagnosed at an advanced stage. In the patient, they often first become noticeable with reduced visual acuity and increased sensitivity to glare.
Severe corneal opacity can lead to progressive opacity and ultimately blindness without treatment.
- In the early stages, laser therapies can prevent progression and lead to healing.
- In more advanced stages, a corneal transplant can help preserve vision in the long term. However, both laser treatment and surgical therapy carry their own risks and renewed clouding can occur.
In order to be able to start treatment at an early stage, it is therefore advisable to consult an ophthalmologist at an early stage if you have visual problems. If the corneal opacity is a side effect of a surgical procedure or an injury, it usually heals on its own.
You might also be interested in the following articles: Corneal transplant, blindness
What is the prognosis for corneal opacity?
The donor cornea usually heals in without any problems and retains its clear state.
Often the eyesight is much better after the operation than before, or at least an impending progressive deterioration can be prevented.
In about 10% of the cases of corneal transplants, however, intolerance reactions occur, which can result in severe clouding of the donor cornea.
If such rejection reactions occur, a new corneal transplant should be performed. To prevent such reactions, cortisone-containing drugs are given as eye drops after the operation.
What complications can corneal opacity cause?
Structures in the vicinity can be damaged by the procedure and allergic reactions cannot be ruled out. Bleeding / secondary bleeding is rarely possible.
Inflammation, healing disorders and excessive scarring occur in individual cases.
New cloudiness was also observed, so that a reoperation was necessary.
Retinal damage can rarely develop and with particularly severe complications, blindness or loss of the affected eye is possible.
After a cornea transplant, ametropia is often present.
Is corneal opacification curable?
In most cases, corneal opacity heals on its own. If the opacity progresses, laser therapy can lead to healing in the early stages. In more advanced stages, a corneal transplant can help prevent blindness.
