Corneal Anomalies

The cornea represents the clear window in front of the eyeball. This is the most important refractive surface we have in the refractive anatomy of the eye. It accounts for 2/3 of the eyes refractive power, the air/tear film interface. If the cornea is irregular, the image will be blurry. If the cornea has astigmatism, the person will see a distorted image. The cornea is approximately the size of a dime, 550 microns in thickness or about 10-11 millimeters. Frequently, the cornea can be associated with reduction and transmission of light because of an inheritable disease called Fuch’s corneal dystrophy. Fuch’s corneal dystrophy is seen more frequently in women by a factor of 3:1 and results in thickening of the cornea and the loss of transmission of light. Various procedures are available for this condition; such as PKP (Penetrating Keratoplasty) a through and through-thickness corneal transplant, DSAEK procedure (Descemet’s Stripping Automated Endothelial Keratoplasty) to remove the posterior endothelial cells which are deficient in number with the replacement of graft tissue and DMEK or Descemet’s Membrane Endothelial Keratoplasty. These procedures are the mainstay of modern corneal transplants for endothelial dystrophies.

Regarding corneal scarring, PKP is the mainstay of therapy. This is the most common procedure performed for local burns to the cornea.

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