Doctor in Cornea Clinic Dr. Geet Shah
Treatment of Red Eyes
Treatment of Dark Circle
Treatment of Eye Pain
Treatment of Conjunctivitis
Treatment of Weak Eyes
Treatment of Black eye
Treatment of Eye Itching
Treatment of Eye Infection
Treatment of Tearing Eyes
Treatment of Eye Burning
Treatment of Myopia
Treatment of Eye Allergy
Treatment of Poor Eye Sight
Management of Blindness
Treatment of Dry Eyes
Treatment of Cataract
Treatment of Squint
Treatment of Watery Eyes
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Ulcers and perforations of cornea are some very serious clinical conditions, which threaten vision rapidly and progressively, and disintegrate the eye globe. They need to be taken care of immediately to prevent irreparable damage to the eyes. In spite of the advanced medical research and practice, severe injuries, infections, and diseases of cornea can lead to serious corneal perforations, which require surgery necessarily as the ultimate solution.
Urgent reconstructive surgery might be necessary to avoid consecutive endophthalmitis, formation of synechiae (anterior and posterior), and secondary glaucoma to prevent spread of pathogens toward posterior pole of eye globe. This surgery is also performed to avoid other severe complications including inflammation.
The approach of performing surgery to retain corneal integrity depends on localization, size, state of internal globe tissue, and depth and severity of corneal tissue damage. The state of inflammation and causative infection influences the choice and sequence of surgeries. Urgent Penetrating Keratoplasty, Total Penetrating Keratoplasty, and Corneal or Corneo Scleral Patch Graft, or combination of surgical approaches, also called ‘Keratoprosthesis’, which are performed only for end-stage, progressive corneal pathology, or the last-chance medical treatment.
Ramon Castroviejo, in 1951, described Penetrating Keratoplasty as a method to replace a larger diseased cornea and sclera lying adjacent to it with donor tissue.
The goal of Penetrating Keratoplasty is tectonic repair of large corneal perforations to restore the integrity of the eye globe and correcting or resolving many other conditions of the eye simultaneously.
When to Perform Penetrating Keratoplasty?
Penetrating Keratoplasty is performed for perforated cornea in the following cases:
Keratoconus and ectasias.
Corneal dystrophies including Fuchs endothelial dystrophy.
Noninfectious ulcerative keratitis.
Post infectious keratitis.
Microbial keratitis including Fungal and Bacterial keratitis.
Regraft unrelated to allograft rejection.
Regraft related to allograft rejection.
Surgical procedure involves the following steps:
Preparation of donor tissue is the first step. A corneal button slightly larger than the host corneal opening helps in reducing post-surgical excessive corneal flattening, reducing risk of secondary glaucoma, and enhancing closure of wound.
Afterwards, host cornea is trephined; viscoelastic is filled into the anterior chamber followed by placement of donor tissue on the endothelial side down of recipient's eye.
Cornea is then sutured in place, interruptedly or continuously. Interrupted sutures are preferred in inflamed, vascularized, or thinned corneas and in paediatric cases.
Penetrating Keratoplasty is the true and last-chance medical treatment to treat large corneal perforations. It is the only ophthalmologic surgical procedure which restores ocular integrity, and at the same time takes care of infections, inflammations, and necrotic tissue. Such a holistic approach minimizes the risk of endophthalmitis and prevents the spread of disease to the globe of the eye. It also improves the probability of graft survival and has a good potential to improve visual acuity.
Penetrating Keratoplasty is an effective surgical process. However, it is always advisable to consult an experienced and skilled surgeon before opting for this method.
Dry eyes are a common phenomenon that develops when the tears do not provide sufficient moisture to your eyes. This may also be the result of inadequate production of tears by the tear ducts. This condition cannot be cured permanently; however, treatments usually help.
Signs and symptoms of dry eyes:
1. A scratchy, burning and a stinging sensation in the eyes
2. Mucous surrounding the eyes
3. Sensitivity to light
4. Redness of the eyes
5. A feeling that something is stuck in the eyes
6. Problems in wearing contact lenses
7. Vision problems, especially while driving at night
8. Watery eyes caused due to the irritation that stems from dry eyes
9. Blurred vision
What are the causes?
1. Tears are a mix of fatty oils, water and mucus. This combination safeguards your eyes from any sort of infection in addition to keeping your ocular surface (the cornea surface) clear and smooth. Your eyes dry up if the tear ducts do not produce enough tears; medically, this condition is termed ‘keratoconjunctivitis sicca’. It can occur due to:
- Certain medical complications such as Sjogren’s Syndrome (a medical condition marked by dry eyes and a dry mouth) arthritis, diabetes, thyroid disorders and deficiency of Vitamin A among a few others
- Side effects of certain medications such as anti-depressants, acne medications, birth control medications and medicines to control high blood pressure
- Laser eye surgery or damage caused to the tear gland due to exposure to radiation or inflammation
2. Increased drying up or evaporation of the tears caused due to exposure to various kinds of smoke, dry air or wind, less of blinking while focusing on any particular activity or an object and eye lid problems such as in-turning of the eyelids (entropion) and out-turning of the eyelids (ectropion) can contribute to this irritating condition.
3. Imbalance in any of the layers constituting a tear film (made of oil, mucus and water) might lead to this condition.
Astigmatism is an eye condition where there is an imperfection in the curvature of the cornea. The cornea and lens are smooth and equally curved in all directions, which helps to focus the light rays to the retina. But if there is an imperfection in the curvature, then you will suffer from a refractive error. Astigmatism is not an eye disease. It is simply a condition where the eye is not able to focus the light.
Irregular shape of the cornea is the main cause for astigmatism. It might also be caused because of the imperfect shape of the lens. Suffering from astigmatism is very common. You are either born with the condition or you might have developed it after an eye surgery. It is an incorrect concept that watching too much of television or reading without enough light causes astigmatism.
There are three different types of astigmatism:
- Myopic astigmatism: When the principal meridians of the cornea are nearsighted.
- Hyperopic astigmatism: When the principal meridians of the cornea are farsighted.
- Mixed astigmatism: When one of the principal meridians is nearsighted and the other is farsighted.
It can also be classified in two other types:
- Regular astigmatism: When the principal meridians are perpendicular to each other.
- Irregular astigmatism: When the principal meridians are not perpendicular to each other.
Blurry or distorted vision, strain in the eye, eye discomfort, squinting and headaches are a few symptoms of astigmatism
If you notice the symptoms stated above, make sure you pay a visit to your ophthalmologist. If you are suffering from astigmatism, your doctor will do an eye test to check how much your eye is able to focus on light. After conducting his tests, he will determine how much power you have and you will have to wear glasses of that power. Apart from the option of wearing glasses or artificial lenses, you can also go for a surgery to correct the condition. LASIK is an option among the many other options of surgeries available.
LASIK or laser in situ keratomileusis, is a form of corrective surgery that help patients who are suffering from near sightedness (Myopia), far sightedness(Hypermetropia) and even astigmatism (cylindrical power in glasses). This procedure aims at correcting the shape of the cornea, which is the transparent layer that lines the front of the eye. Through this procedure, the cornea is reshaped so that the retina receives a focused light.
So what are the health tips for people going through a LASIK procedure? Here is our take:
Biggest advantage of LASIK is that it helps people to get rid of Glasses and contact lenses, which sometimes are cosmetically unacceptable and in some cases are visually disabling.
Best part of LASIK is that it is:
- Quick (total duration of surgery is hardly 5 minutes) and virtually painless.
- Has a high success rate ( success rate is 96%).
- Does not require bandages or stitches.
- Adjustments can be made years later to alter the vision as per growing impairment in the future and advancing years.
Minor side effects like dryness, glare and halos, if appear, subside with time.
Any person 18 yrs or older who fulfils the following criteria can undergo Lasik surgery
- Stable refraction
- Corneal thickness and topography should be in normal range
- Dilated retinal examination should be normal
- Adequately wet eyes
Note: One should abstain from wearing contact lens at least 2 weeks before the procedure.
Precaution after the Procedure:
Patient is likely to have some inflammation after the procedure and temporary dryness.
Use medicines as prescribed by the doctor
- Avoid any type of eye makeup for at least 1 month after surgery
- Avoid swimming or water sports for at least 2- 3 weeks after surgery
Going through a LASIK procedure is a matter of finding the right specialist and ensuring that you take all the precautions before the procedure. Also, it is important to look into your medical history and eyes in particular so as to avoid complications.