As a premier eye care center in Colorado, our doctors offer patients
the care their Cornea needs throughout life.
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The cornea is the clear front window of the eye. It vaults over and protects the iris (the colored part) and pupil (the black center). The cornea is part of the tough wall of the eye, and because it i s clear, it also focuses light. Light from the cornea is sent through the pupil into the lens, and then on to the retina. The shape and curvature of the cornea helps determine if the eye is nearsighted, farsighted or has some astigmatism. The cornea actually focuses over 50% of the light that enters the eye and is in charge of 2/3 of our focusing power!
Because the corneal exposed to the air, like the windshield of an automobile, or outside of the TV monitor, the cornea is subject to considerable abuse from the outside world. Particles of dust and foreign materials inevitably find their way onto the eyes, irritating them and stimulating the production of tears to wash the foreign materials away. When the corneal tissue is disrupted by dry eye, keratoconus, or other corneal disease, the visual system is disrupted. The surface of the cornea needs to be wet, smooth and regular to obtain the best vision. Dry eye, eyelid disease and hereditary corneal diseases can cause visual blur that cannot be corrected with glasses or cataract surgery.
InSight Vision Center provides care for many corneal issues to include dry eye, keratoconus, pterygium, pinguecula, PKP and DSEK.
Keratoconus is when the cornea protrudes, becoming progressively thinner, bulging into a steep cone. The result is poor vision with severe nearsightedness and astigmatism. Keratoconus is usually in both eyes with differing levels of severity. There are several treatment options that your doctor may recommend including Corneal Cross Linking and Corneal Transplantation.
Corneal Collagen Cross Linking is a relatively pain free procedure that is performed to slow or stop the progression of Keratoconus. Currently, there is not a cure for Keratoconus, however Cross Linking slows or halts the progression of the disease to prevent the cornea from becoming more irregular. We use special eye drops and an advanced form of UV light to strengthen your cornea.
Patients that are good candidates for Cross Linking:
Based on study results of over a decade, it appears that the strengthening effects may be permanent. Cross Linking is FDA approved. The doctor will have a comprehensive discussion, at your consultation, of the risks, benefits and alternatives to the proposed treatment. The procedure normally takes 45 minutes and you will be in our center for approximately 2 hours on the day of your procedure.
If the eye surface is irritated by UV exposure or dryness over several years, it can become slightly thickened. Such areas are generally observed at the 3:00 and 9:00 position, where the eyelids meet during blinking. Most often, if these small “bumps” become red or irritated, they are treated with lubricants or anti-inflammatory drops. In severe cases, they can be surgically removed.
When a pingueculum continues to grow, it can start to cover the edge of the clear cornea, and now it is called a “pterygium”. These are local changes in tissue and do not represent cancer. They can vary in appearance from looking like a mild focal pinkeye to larger white patches with overlying red blood vessels. They are generally caused by sun exposure, low humidity, dry eyes, or genetics. Although they are not harmful, they can cause issues with vision, irritation and appearance. They may at times be confused with
other problems such as infections or tumors, so that seeing your eye doctor is always recommended. If removal is needed or desired, our surgeon will evaluate and discuss treatment/surgical options you. The growth can be surgically removed using various techniques that are individualized to the specific patient. Even with the best of surgeries, these growths can recur, so wearing sunglasses and preventing dry eye is important before and after such surgery. In addition, your primary eye doctor can also recommend other treatments to help prevent worsening or recurrence.
Descemet’s Stripping with Endothelial Keratoplasty (DSEK) is a newer cornea transplant technique that replaces the damaged innermost cell layer (endothelium) tissues instead of replacing the entire thickness of the cornea. It is used when the inner cell layer of the cornea cannot function , and the cornea then becomes swollen. Compared to Penetrating Keratoplasty (PKP), the cornea heals much faster, is stronger, is less likely to be rejected, and the patient’s visual recovery is faster. Because this technique does not adversely affect the corneal surface and thus significantly improves the visual results, it has become a preferred method for treatment of Fuchs’ Dystrophy and pseudophakic bullous keratopathy.
The DSEK procedure is done under local anesthesia and takes approximately 30 minutes. No sutures are required as the main structure of the cornea remains intact, leading to a faster visual recovery and less astigmatism. For the first 24 hours after surgery patients are asked to lie on their back with their face pointed directly to the ceiling for as much time as they can tolerate. This helps the graft stay in position as an air bubble holds it in place on the inside surface of the cornea.
Patients are given several drops to use to prevent infection as well as to help the eye heal comfortably. There are minimal activity restrictions after the first 48 hours. The vision is usually better within one week. About 80% of the healing has taken place by one month, and the vision can continue to slowly improve over the next four to six months.
If both the front and inner corneal layers of your eye are damaged then you may need a penetrating keratoplasty (PKP), which is a full thickness corneal transplant. This surgery is done under general anesthesia. A clear donor cornea will be sewn in place where your diseased or damaged cornea was. The recovery period for this transplant is longer than with other corneal transplant surgeries. You will be given several drops to use to prevent infection and to help the eye heal comfortably. There is a slightly higher risk of rejection: your body’s immune system fights the new cornea. Additionally, it is a longer visual recovery after PKP and may take longer than a year for you to have better vision. Every patient is unique, and your surgeon will discuss the risks and benefits for your specific case.