Dr. Ashwini P Misal

The cornea refers to the dome-like structure visible at the front of the eye. This is the outermost layer of the eye. The cornea protects the eye against germs, dirt and other harmful particles and helps focus light coming into the eye onto the retina to create an image. It also acts as a filter against UV radiation produced by the sun. In the case of injuries to the cornea due to scarring or eye diseases a corneal transplant may be advised. This is also known as keratoplasty.

The first step for a corneal transplant is to add the patient’s name to the transplant list at the local eye bank. A transplant can only be performed after a donor's eye is made available. The surgery is usually performed as an outpatient procedure and takes a maximum of 2 hours.

Local or general anaesthesia may be used for this procedure depending on the patient’s age, overall health and personal preference. A lid speculum is then used to keep the eyelids open through the surgery. A circular section of the injured cornea is then removed using a surgical tool or a laser beam. A matching section from the donor cornea is then used to replace the removed section and stitched into place. These stitches usually stay in place for a year after the surgery.

The healing of the cornea is a slow process and hence to prevent any injuries to the eye, a protective shield is usually worn over the eye for a few months. Patients may experience mild discomfort and blurred vision for the first few months after surgery. Steroid eye drops may also be prescribed to help the body accept the transplant and control infections. These eye drops will need to be used for up to a year after the surgery. As the cornea heals, the patient’s vision will improve. The results of a corneal transplant are said to have a life of about 10 years. However, this depends on the root cause of the problem.

Corneal transplants have a very high success rate but in rare cases, the eye may reject the transplant. Glaucoma and corneal swelling caused by an earlier cataract surgery can increase this risk. However, if this rejection is detected early enough, the process can be reversed. Some signs to look out for that may indicate that your body is rejecting the transplant are increased sensitivity to light, redness, pain and decreased vision.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Diabetes is a pervading disease as it does not spare any system of your body. The increased sugar level affects everything from circulation to vision to kidneys. Diabetes is the leading cause of blindness in the eyes in the age group of 25 to 75.

Some of the common eye problems caused by diabetes are listed below

1. Blurred vision: Increased sugar levels can cause blurred vision. While most people might jump to getting a corrective lens, it may not be needed in all cases. Try getting the sugar levels to normal levels and see the vision improve. It may take up to 3 months, but it is definitely possible to do away with the lens.
2. Cataracts: Clouding of the lens which is known as cataracts can set in early when there is diabetes. Worsening of cataracts also is at a quicker pace with diabetics. The blurring of vision and glare can set in, which would require removal of the clouded lens and placement of an artificial lens.
3. Glaucoma: There is always a certain amount of pressure on the eyes, known as intraocular pressure. This pressure increases significantly in diabetics, leading to vision changes and damage to nerves and blood vessels. Glaucoma can cause dryness in the eyes, as there is less amount of liquid that the eye makes. There could also be headaches, eye pains, blurred vision, and vision loss. In addition to eye drops, surgery and laser can also be used for correction.
4. Diabetic retinopathy: The retina is a layer on which image of an object falls, and from there, a message is sent to the brain to identify an object. However, in people with increased sugar levels, the blood vessels in the retina can be damaged, leading to vision problems and even blindness. Greater the sugar levels, greater the damage. There could be people who have lost vision due to this condition. Periodic checkups are advised to ensure that the vision is constantly monitored. There could be black spots or holes in the vision, flashes of light, and even blurring of vision gradually resulting in a complete loss.

Some eye care tips:

Now that we know diabetes affects the eyes adversely, the following are some effective tips to ensure good eye health is maintained.

1. If sugar levels are not well controlled, more frequent checkups are advised, else, annual checkup should suffice.
2. Monitor and control the blood sugar and A1c levels
3. Monitor and control blood pressure levels, as combined with higher blood sugar levels, the damage is exponential
4. Quit smoking
5. Monitor and control cholesterol levels
6. Healthy diet with lots of vitamins, minerals, and protein
7. Exercise to help in improving overall quality of life. If you wish to discuss about any specific problem, you can consult an Ophthalmologist.