Understanding Neurotrophic Keratitis (NK)

Neurotrophic keratitis is a rare condition. It happens when the corneal nerves are damaged which causes a loss of feeling in the cornea. This impairment disrupts corneal healing and leaves the eye susceptible to injuries and infections. NK progresses in three stages:

• Stage 3 – Severe complications, including corneal perforation.

• Stage 1 – Superficial punctate keratitis with mild discomfort.

• Stage 2 – Persistent epithelial defects and corneal ulcers.

What are the symptoms of Neurotrophic Keratitis

Neurotrophic Keratitis is characterized by impaired corneal sensory innervation, which often leads patients to overlook ocular surface symptoms. This lack of awareness can make diagnosing Neurotrophic Keratitis particularly challenging, as individuals may seek medical attention months or even years after the onset of the condition. In the early stages, patients may not exhibit any noticeable symptoms due to reduced corneal sensitivity. Consequently, they often do not report pain or discomfort in the eye. However, symptoms such as blurred vision, redness, dryness, and decreased visual clarity may eventually develop. Additionally, affected individuals may become highly sensitive to light.

The compromised cornea is more prone to injury and heals at a slower rate compared to a healthy cornea, increasing its vulnerability to damage. Patients may also experience frequent or recurrent corneal erosions, which occur when an opening forms in the epithelial layer. Since this layer serves as the cornea’s protective barrier, any epithelial defect can heighten the risk of infection.

What causes Neurotrophic Keratitis

Neurotrophic keratitis can be caused by any condition or disorder that affects the nerves that serve the cornea. The main nerve that serves the cornea is called the trigeminal nerve, which is also called the fifth cranial nerve. Damage to the ophthalmic division of the trigeminal nerve, which serves the cornea, can cause neurotrophic keratitis. When the nerves that serve the cornea are damaged this causes reduced sensitivity of the cornea and can lead to neurotrophic keratitis.

How is Neurotrophic Keratitis Diagnosed

Testing corneal sensation is crucial for accurate diagnosis, typically utilizing tools such as the Cochet-Bonnet esthesiometer or more informal methods like cotton wisp tests. Advanced imaging techniques, slit lamp evaluations, and fluorescein staining may also be used to assess the cornea’s condition. Diagnosing neurotrophic keratopathy is generally straightforward, relying on patient history and examination findings. It is essential to note that a decrease in corneal sensation is a common finding across all cases.

In stage 1 of the disease, punctate epithelial staining with fluorescein is a nonspecific indicator and may also be present in other conditions, including dry eye syndrome, blepharitis, chronic eye rubbing, exposure keratopathy, topical drug toxicity, ultraviolet keratopathy, mild chemical injury, contact lens-related disorders, and corneal limbal stem cell deficiency. A thorough medical and surgical history is vital for differentiating among these potential diagnoses.

If the cornea exhibits an ulcerated appearance, it is important to consider other underlying causes, including infectious and immune-related conditions. Appropriate cultures should be obtained, and an immune work-up may be warranted.

Treatment Options for Neurotrophic Keratitis

NK treatment focuses on protecting the cornea, preventing infections, and promoting healing. The approach depends on the stage and severity of the condition:

Non-Surgical Treatments for Neurotrophic Keratitis

• Artificial Tears and Lubricants: Preservative-free drops, gels, or ointments to maintain moisture.

• Autologous Serum Tears: Rich in regenerative components like growth factors, they aid healing.

• Topical Medications: Include cyclosporine, lifitegrast, or recombinant human nerve growth factor (Oxervate) to stimulate nerve regeneration and healing.

• Amniotic Membrane Therapy: A biological scaffold that promotes healing and reduces inflammation.

• Bandage or Scleral Contact Lenses: Protect the cornea from trauma and support epithelial healing.

• Punctal Occlusion: Retains natural tears by blocking tear drainage.

Surgical Treatments for Neurotrophic Keratitis

• Tarsorrhaphy: Temporarily or permanently narrows the eyelid opening to protect the cornea.

• Corneal Neurotization: A cutting-edge surgical technique that restores corneal nerve function by grafting healthy nerve tissue. While highly specialized, this procedure has shown promising results in nerve regeneration.

Advanced Therapies for Neurotrophic Keratitis

Oxervate (cenegermin) is a groundbreaking treatment is the first of its kind to receive FDA approval specifically aimed at addressing the underlying cause of neurotrophic keratitis (NK). It works by stimulating epithelial healing through the action of nerve growth factors, promoting recovery and restoration.

Why Early Treatment for Neurotrophic Keratitis Matters

Timely intervention in NK is critical to prevent permanent vision loss and manage complications. Patients with conditions such as diabetes, herpes infections, or those who’ve undergone surgeries like LASIK are at higher risk and should be vigilant about symptoms.

Meet Our Corneal Neurotization Surgery Expert

麻豆高清provides expert care for neurotrophic keratitis, utilizing the latest diagnostic tools and tailored treatment plans, including innovative therapies like Oxervate and advanced surgical options. Our dedicated team of specialists is committed to preserving your vision and enhancing your quality of life.

Leon Rafailov, MD is a board-certified, fellowship-trained ophthalmic plastic surgeon specializing in a comprehensive range of plastic and reconstructive surgeries around the eyes. His expertise encompasses the eyelids, forehead, mid-face, orbit, and tear ducts. Dr. Rafailov has successfully performed thousands of reconstructive, cosmetic, functional, and orbital surgeries. He has also published numerous journal articles, abstracts, and book chapters on various topics within oculoplastics.

Trained in advanced techniques for minimally invasive endoscopic surgery, facial reconstruction, trauma surgery, orbital surgery, oncologic surgery, and cosmetic surgery, Dr. Rafailov is well-equipped to provide exceptional care. During his fellowship at Duke, he contributed to research on corneal neurotization and was honored with the “Fellow of the Year” award for his teaching contributions. He takes pride in delivering specialized, patient-centered care, employing a customized approach for each individual. His patients appreciate his personalized and attentive care.

Sources: American Academy of Ophthalmology, NIH, Ophthalmology Management.銆�8銆戙赌�9銆戙赌�10銆�

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Before delving into the signs of a corneal ulcer, let’s briefly review what a corneal ulcer is and how it develops. A corneal ulcer is a localized infection or inflammation of the cornea, typically caused by bacteria, viruses, fungi, or other microorganisms. Factors such as trauma, contact lens wear, dry eye syndrome, and underlying medical conditions can increase the risk of corneal ulcers. Corneal ulcers can cause significant discomfort and vision problems if left untreated.

Signs and Symptoms of Corneal Ulcers

Corneal ulcers can present with various signs and symptoms, which may include:

1. Eye Pain: Corneal ulcers often cause severe eye pain, which may worsen with blinking or movement of the eye.
2. Redness: The affected eye may appear red or bloodshot due to inflammation and irritation.
3. Blurred Vision: Vision may become blurred or hazy as a result of the corneal ulcer affecting the clarity of the cornea.
4. Sensitivity to Light: Photophobia, or sensitivity to light, is common in individuals with corneal ulcers, leading to discomfort in bright environments.
5. Excessive Tearing: The eye may produce excess tears in response to irritation and inflammation caused by the corneal ulcer.
6. Foreign Body Sensation: Some individuals may experience a sensation of having a foreign object or grit in the eye.
7. Eye Discharge: Corneal ulcers can cause discharge from the eye, which may be watery, purulent (pus-like), or mucopurulent (mixture of mucus and pus).

Causes of Corneal Ulcers

Corneal ulcers can be caused by a variety of factors, including:

1. Bacterial Infections: Common bacteria such as Staphylococcus aureus or Pseudomonas aeruginosa can cause corneal ulcers, particularly in individuals who wear contact lenses or have compromised immune systems.
2. Viral Infections: Herpes simplex virus (HSV) or varicella-zoster virus (VZV) can lead to viral keratitis and the development of corneal ulcers.
3. Fungal Infections: Fungal keratitis, often associated with trauma or agricultural injuries, can result in corneal ulcers caused by fungi such as Fusarium or Aspergillus species.
4. Trauma: Corneal abrasions or injuries, including those caused by foreign bodies or contact lens misuse, can create a pathway for infection and ulceration.
5. Dry Eye Syndrome: Insufficient tear production or poor tear quality can compromise the cornea’s integrity and increase the risk of corneal ulcers.

Treatment Options for Corneal Ulcers

Prompt diagnosis and treatment are essential for managing corneal ulcers and preventing complications. Treatment options for corneal ulcers may include:

1. Topical Antibiotics: Broad-spectrum antibiotics are typically prescribed to treat bacterial corneal ulcers and prevent further infection.
2. Antiviral Medications: In cases of viral keratitis, antiviral medications may be prescribed to control viral replication and reduce inflammation.
3. Antifungal Agents: Fungal corneal ulcers require treatment with antifungal medications, which may be administered orally, topically, or through intravenous infusion.
4. Lubricating Eye Drops: Lubricating eye drops or ointments can help soothe the eye and alleviate discomfort associated with corneal ulcers.
5. Corneal Patching: In some cases, a therapeutic contact lens or bandage contact lens may be placed over the cornea to protect the ulcer and promote healing.
6. Surgical Intervention: Severe or persistent corneal ulcers may require surgical intervention, such as corneal debridement, amniotic membrane transplantation, or corneal grafting.

Corneal Disease Care at 麻豆高清

Corneal ulcers are a serious eye condition that requires prompt evaluation and treatment to prevent vision loss and complications. If you experience any signs or symptoms of a corneal ulcer, such as eye pain, redness, blurred vision, or sensitivity to light, it’s crucial to seek immediate medical attention from an experienced ophthalmologist or eye care professional. At SightMD, our team of skilled ophthalmologists and eye care specialists is dedicated to providing prompt evaluation and comprehensive treatment for corneal ulcers and other eye conditions. Don’t delay鈥�book your appointment at 麻豆高清today and take the first step towards preserving your vision and eye health.

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The cornea is a transparent, dome-shaped tissue that covers the front of the eye, playing a crucial role in focusing light and maintaining clear vision. However, when the cornea becomes infected, it can lead to significant discomfort and vision impairment. Corneal infections, also known as keratitis, can be caused by bacteria, viruses, fungi, or parasites, and prompt treatment is essential to prevent complications and preserve vision. At SightMD, we’re dedicated to providing comprehensive care for corneal infections, offering effective treatment options tailored to each patient’s needs.

1. Antibiotic Eye Drops: In cases of bacterial keratitis, antibiotic eye drops are typically the first line of treatment. These medicated drops work to eliminate the infection-causing bacteria and reduce inflammation in the cornea. Depending on the severity of the infection, your ophthalmologist may prescribe broad-spectrum or specific antibiotics to target the underlying cause effectively. It’s crucial to use antibiotic eye drops as directed and complete the full course of treatment to ensure the infection is fully eradicated.
2. Antifungal Medications: For fungal keratitis, antifungal medications such as antifungal eye drops or oral antifungal agents may be prescribed. These medications work to inhibit the growth and spread of the fungal infection within the cornea. In severe cases, your ophthalmologist may recommend a combination of topical and systemic antifungal therapy to achieve optimal results. Close monitoring and regular follow-up appointments are essential to assess treatment efficacy and prevent recurrence of the infection.
3. Antiviral Medications: In cases of viral keratitis, antiviral medications are used to suppress viral replication and reduce inflammation in the cornea. Depending on the specific virus involved, your ophthalmologist may prescribe topical antiviral eye drops, oral antiviral medications, or a combination of both. While antiviral medications can help manage the symptoms of viral keratitis, they may not fully eliminate the virus, and recurrence is possible. Regular follow-up appointments and ongoing monitoring are essential to manage the condition effectively.
4. Corticosteroid Eye Drops: In some cases of corneal infection, corticosteroid eye drops may be prescribed to reduce inflammation and promote healing in the cornea. However, corticosteroids are typically used in combination with antimicrobial medications and under close supervision by your ophthalmologist. Prolonged or inappropriate use of corticosteroids can exacerbate the infection and lead to complications, so it’s essential to follow your doctor’s instructions carefully.
5. Corneal Debridement or Surgery: In severe cases of corneal infection that do not respond to conservative treatment measures, surgical intervention may be necessary. Corneal debridement, or the removal of infected tissue from the cornea, may be performed to eliminate the source of the infection and promote healing. In advanced cases or when vision is significantly compromised, corneal transplantation surgery may be recommended to replace the damaged corneal tissue with healthy donor tissue.

Cornea Disease Care at SightMD

Corneal infections can cause significant discomfort and vision impairment if left untreated. Prompt diagnosis and appropriate treatment are essential for preserving vision and preventing complications. At SightMD, our team of experienced ophthalmologists is dedicated to providing comprehensive care for corneal infections, offering a range of treatment options tailored to each patient’s unique needs. If you’re experiencing symptoms of a corneal infection, don’t hesitate to schedule an appointment for evaluation and treatment.

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Keratoconus is a progressive eye disorder that affects the shape of the cornea, causing it to thin and bulge into a cone-like shape. While glasses and contact lenses can help manage the symptoms in the early stages, some patients may eventually require surgery to improve their vision and halt the progression of the disease.

Understanding Keratoconus

Before delving into surgical options, it’s essential to understand what Keratoconus is and how it affects vision. Keratoconus typically begins during the teenage years or early adulthood and can lead to blurry vision, increased sensitivity to light, and distorted vision. As the disease progresses, it can significantly impact daily activities and quality of life.

Indications for Keratoconus Surgery

Keratoconus surgery is typically recommended for patients who experience significant vision loss or are unable to achieve adequate vision correction with glasses or contact lenses. Additionally, surgery may be considered to prevent further deterioration of the cornea in advanced cases of the disease.

Types of Keratoconus Surgery

There are several surgical options available for treating Keratoconus, each tailored to the individual patient’s needs and the severity of their condition. Some of the most common surgical procedures include:

1. Corneal Cross-Linking (CXL): This minimally invasive procedure involves applying riboflavin (vitamin B2) eye drops to the cornea, followed by exposure to ultraviolet light. CXL helps strengthen the cornea and halt the progression of Keratoconus.
2. Intacs Inserts: Intacs are small, crescent-shaped implants that are placed within the cornea to flatten and reshape its curvature. This can help improve vision and reduce the irregular astigmatism associated with Keratoconus.
3. Corneal Transplant (Penetrating Keratoplasty or DALK): In severe cases of Keratoconus where the cornea is significantly scarred or thinned, a corneal transplant may be necessary. During this procedure, the damaged cornea is replaced with healthy donor tissue to restore vision.

The Keratoconus Surgical Process

Prior to undergoing Keratoconus surgery, patients will undergo a comprehensive eye evaluation to assess their eligibility and determine the most appropriate treatment approach. The surgical process itself varies depending on the procedure but is typically performed on an outpatient basis under local or general anesthesia.

Recovery and Follow-Up Care

Following Keratoconus surgery, patients will need to follow specific post-operative instructions provided by their surgeon to ensure proper healing and optimal visual outcomes. Recovery times vary depending on the type of surgery performed, but patients can generally expect to experience some discomfort and temporary changes in vision during the initial healing period.

Treating Keratoconus at SightMD

Keratoconus surgery offers hope for patients struggling with vision loss due to this progressive eye disorder. By understanding the available surgical options, the procedure process, and what to expect during recovery, patients can make informed decisions about their treatment and take proactive steps to preserve their vision. If you or a loved one is living with Keratoconus, don’t hesitate to consult with the experienced ophthalmologists at SightMD. Our team is dedicated to providing personalized care and innovative treatment options to help patients achieve clearer vision and improved quality of life. Schedule a consultation today to learn more about Keratoconus surgery and how we can help.

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The cornea is a transparent, dome-shaped structure that covers the front of the eye and plays a crucial role in focusing light onto the retina, enabling clear vision. However, like any other part of the body, the cornea can be affected by various diseases and conditions that can impact its function and clarity.

Understanding Corneal Diseases

Corneal diseases can range from mild conditions, such as dry eye syndrome, to more severe conditions, such as keratoconus or corneal ulcers. Some common corneal diseases include:

• Keratoconus: A progressive condition characterized by the thinning and bulging of the cornea, leading to visual distortion and decreased vision.

• Fuchs’ Dystrophy: A condition in which the corneal endothelial cells gradually degenerate, leading to corneal swelling and impaired vision.

• Corneal Ulcers: Open sores on the cornea, often caused by infection or injury, which can lead to pain, redness, and vision loss.

• Corneal Abrasions: Scratches or cuts on the cornea, often caused by trauma or foreign objects, which can lead to pain, redness, and discomfort.

Treatment Options for Corneal Diseases

The treatment options for corneal diseases vary depending on the specific condition and its severity. Some common treatment options include:

• Medications: Topical or oral medications, such as antibiotics or anti-inflammatory drugs, may be prescribed to manage corneal infections or inflammation.

• Eye Drops: Lubricating eye drops or artificial tears may be used to relieve symptoms of dry eye syndrome or to help promote healing in cases of corneal abrasions.

• Contact Lenses: Specialty contact lenses, such as scleral lenses, may be used to improve vision and comfort in patients with corneal irregularities, such as those seen in keratoconus.

• Surgical Procedures: In some cases, surgical procedures may be necessary to treat corneal diseases. These may include corneal transplant surgery (keratoplasty), in which the diseased cornea is replaced with a healthy donor cornea, or procedures to reshape the cornea, such as photorefractive keratectomy (PRK) or laser-assisted in situ keratomileusis (LASIK).

Corneal Disease Specialists at SightMD

The question of whether corneal diseases can be cured depends on the specific condition and its underlying cause. In some cases, such as corneal abrasions or infections, the condition may be temporary and can be effectively treated and resolved with appropriate medications and care. However, for chronic or progressive corneal diseases, such as keratoconus or Fuchs’ dystrophy, a cure may not be achievable. In these cases, the goal of treatment is often to manage symptoms, slow disease progression, and preserve vision for as long as possible. This may involve a combination of medications, contact lenses, and surgical interventions.

While a cure may not always be possible for corneal diseases, there are effective treatment options available to manage symptoms, improve vision, and preserve eye health. If you are experiencing symptoms of a corneal disease, such as redness, pain, or vision changes, it is essential to seek prompt evaluation and treatment from an eye care professional. Early diagnosis and intervention can help prevent complications and improve outcomes. Your eye health is essential, and with proper care and management, you can maintain clear and healthy vision for years to come. Contact SightMD today so set up an evaluation with one of our Corneal Disease Specialists to discuss your options.

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Among the many components of the eye, the cornea is a vital structure responsible for focusing light onto the retina, enabling us to see clearly. However, certain conditions can affect the cornea, leading to vision problems and discomfort. One such condition is keratoconus, a progressive eye disorder that affects the cornea’s shape and structure. In this blog post, we will explore how keratoconus affects the cornea and its impact on vision.

Understanding Keratoconus

Keratoconus is a condition characterized by the thinning and bulging of the cornea, resulting in a cone-shaped protrusion. This abnormal shape can cause light to be refracted unevenly, leading to distorted or blurred vision. While the exact cause of keratoconus is unknown, it is believed to be a combination of genetic and environmental factors.

How Keratoconus Affects the Cornea

• Thinning of the Cornea: In keratoconus, the cornea gradually thins and weakens, causing it to bulge outward. This thinning can result in a loss of corneal stability and shape irregularities, leading to distorted vision.

• Irregular Astigmatism: As the cornea becomes more distorted, it can create irregular astigmatism, where light entering the eye is not evenly focused. This can cause blurred or double vision, especially at night or in low-light conditions.

• Corneal Scarring: In some cases, keratoconus can lead to corneal scarring, further compromising vision. Corneal scarring can occur due to the stretching and thinning of the cornea, which can cause tears in the corneal tissue.

• Increased Sensitivity to Light: Keratoconus can also lead to increased sensitivity to light (photophobia) due to the irregular shape of the cornea. This can cause discomfort and difficulty with activities such as driving at night or working on a computer for extended periods.

• Decreased Visual Acuity: As keratoconus progresses, visual acuity can decline, making it difficult to see clearly even with corrective lenses. This can significantly impact daily activities and quality of life.

Trust 麻豆高清for Cornea Disease Care

Keratoconus is a progressive eye disorder that affects the cornea, leading to vision problems and discomfort. Understanding how keratoconus affects the cornea is essential for early detection and intervention. If you are experiencing symptoms such as blurred vision, sensitivity to light, or difficulty seeing at night, be sure to contact us today. Early diagnosis and treatment can help manage the condition and preserve your vision for years to come.

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The cornea, the transparent front part of the eye, plays a crucial role in our vision. Unfortunately, various corneal diseases can impact its health, leading to a range of symptoms that can affect our eyesight. In this blog post, we will explore the common symptoms associated with corneal diseases and shed light on how SightMD, a leading eye care provider, can offer effective solutions to address these issues.

Recognizing the Symptoms of Corneal Diseases:

1. Blurred Vision: One of the earliest signs of corneal diseases is blurred vision. The cornea refracts light to focus it on the retina, and any irregularities in its shape or structure can result in distorted vision.
2. Eye Pain and Discomfort: Individuals with corneal diseases may experience eye pain, a sensation of grittiness, or discomfort. These symptoms can be indicative of inflammation or damage to the corneal tissue.
3. Increased Sensitivity to Light: Photophobia, or heightened sensitivity to light, is a common symptom of corneal diseases. Patients may find it challenging to tolerate bright lights, both natural and artificial.
4. Redness and Irritation: Corneal diseases can cause redness and irritation in the eyes. Inflammation and damage to the cornea may lead to a feeling of dryness or the presence of foreign body sensation.
5. Tearing or Watery Eyes: Excessive tearing can be a response to corneal diseases. The eyes may produce more tears as a protective mechanism in response to irritation or inflammation.

How 麻豆高清Can Help: 麻豆高清specializes in comprehensive eye care, including the diagnosis and treatment of corneal diseases. Their team of skilled ophthalmologists and cornea specialists is equipped to address a wide range of conditions affecting the cornea. Here’s how 麻豆高清can help:

1. Advanced Diagnostics: 麻豆高清utilizes state-of-the-art diagnostic tools and technology to accurately assess the health of the cornea. From corneal topography to high-resolution imaging, these diagnostics aid in the precise identification of corneal diseases.
2. Customized Treatment Plans: Once a diagnosis is established, 麻豆高清develops personalized treatment plans tailored to each patient’s specific condition. This may include medications, eye drops, or other therapeutic interventions to manage symptoms and promote corneal health.
3. Corneal Transplants: In cases where corneal diseases have led to significant damage, 麻豆高清offers advanced corneal transplant procedures. Corneal transplantation can replace damaged corneal tissue with healthy donor tissue, restoring vision and improving overall eye health.
4. Collaborative Approach: 麻豆高清takes a collaborative approach to patient care. Their team works closely with individuals, ensuring open communication and involving patients in decision-making regarding their treatment options.

Understanding the common symptoms of corneal diseases is crucial for early detection and effective intervention. With SightMD’s expertise in corneal care, individuals experiencing symptoms such as blurred vision, eye pain, or increased sensitivity to light can find comprehensive solutions tailored to their unique needs. Trust 麻豆高清to safeguard the health of your eyes and provide the advanced care necessary for optimal vision and overall eye wellness.

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• Previous corneal injury (corneal abrasion).
• Corneal dystrophy (map dot fingerprint dystrophy) 鈥� (abnormal structure changes of the cornea).
• Underlying corneal disease.

Who’s at risk?

The most likely victim of recurrent corneal erosion is the person who has had a previous corneal abrasion that was very sharp, clean, and linear, like that from a paper cut. Because the cut is so sharp, without ragged edges, it is less likely to stick down tightly to the underlying basement membrane. Think of gluing two pieces of wood together: if they are exceptionally smooth, they might not adhere as well as if the surfaces were rough. Those who have an abnormal structure to the corneal epithelium (called map-dot-fingerprint dystrophy) are at much greater risk of poor healing following a corneal abrasion and, thus, can develop recurrent corneal erosion.

Signs and Symptoms

Just as it is nearly impossible to see a corneal abrasion with the naked eye, the same is true for recurrent corneal erosion. What is most important is the time course. In recurrent corneal erosion, the patient can remember having had a corneal abrasion relatively recently (usually within the past 3鈥�10 days) and then, most often when first opening the eye in the morning, feels a sudden burst of pain accompanied by symptoms of a corneal abrasion, which are:

• Lots of watery tearing
• Sensitivity to light (especially bright light)
• Blurry vision
• Redness of the eye
• Spasm of the muscles surrounding the eye resulting in squinting
• Feeling that something is in the eye
• Pain

These symptoms may not necessarily mean that you have a corneal erosion or abrasion. However, if you experience one or more of these symptoms, contact your ophthalmologist for a complete exam. These painful conditions commonly arise after a poke from a finger, tree limbs and bushes, or vigorous rubbing of the eye. Sometimes they are caused by contact lenses or other foreign bodies in the eye.

Tests and Diagnosis

Detecting an erosion or abrasion requires the use of fluorescein dye, which highlights the injured tissue during an eye exam. If present, underlying corneal disease also can be diagnosed during an eye exam. Special imaging or other testing is usually not necessary.

Treatment and Drugs

A corneal erosion or abrasion typically heals quickly, often within a few days to a week. It is important not to rub your eye during the healing process as the new epithelial cells are fragile and can easily be rubbed off.  Sometimes your ophthalmologist may choose to patch your eye tightly. This facilitates healing of the damaged corneal epithelium and also reduces pain by preventing the blinking eyelid from irritating the affected area. Since both eyes move together and the eye is most painful when it moves, it is often helpful to rest the other eye as well.

Your ophthalmologist may recommend an antibiotic to prevent infection. Anesthetic drops can relieve pain and facilitate examination but may keep the eye from healing properly if used repeatedly. Anesthetic drops should never be used as a treatment. Long after an abrasion has healed it may spontaneously recur, and is often noticeable upon awakening in the morning. Recurrent corneal erosions often require repeat patching or the use of ointments at bedtime. Sometimes a soft or bandage-type contact lens is used to facilitate healing. Occasionally, treatment of the corneal surface with minor surgery is necessary to prevent recurrences.

If bacteria get into the tissues under the protective corneal epithelium, infection or a corneal ulcer can result. These complications can be very serious and cause loss of vision. Proper care by you and your ophthalmologist are necessary to help prevent serious consequences.

Contact SightMD today to  with one of our doctors to discuss your vision health at one of our convenient locations!

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Keratoconus is a progressive condition characterized by a thinning of the cornea that causes it to lose its symmetrical dome shape. Lopsidedness of the cornea can lead to blurry or distorted vision.

What is keratoconus?

Keratoconus is an eye disorder characterized by the transformation of the cornea from a symmetrical dome to an asymmetric or lopsided cone. The primary function of your cornea is to refract light into your pupil. When light passes through your asymmetrical cornea, it can lead to distortion and blurriness in your vision. Symptoms may start in one eye, but in most cases affects both eyes.

What are the symptoms of keratoconus?

The main sign of keratoconus is a thinning of your cornea that disrupts its natural dome shape. In the early stages of keratoconus, it鈥檚 common to not have any symptoms. As the condition progresses, asymmetry of your cornea can lead to blurred vision and mild to significant distortion of your vision.

Some of the early signs of keratoconus include:

• Rizzuti sign. A steeply curved reflection seen by shining a light on the side of your cornea closest to your temple.
• Fleischer ring. A brown ring of iron deposit around your cornea that鈥檚 most visible with a cobalt blue filter.
• Vogt鈥檚 striae. Vertical lines observed on your cornea that usually disappear when a firm pressure is applied over your eye.

You may also experience:

• corneal swelling
• light sensitivity
• halos in your vision
• eye strain
• irritation
• a persistent desire to rub your eyes
• poor night vision
• nearsightedness (difficulty seeing far away)
• irregular astigmatism (irregular curvature of the eye)

What causes keratoconus?

Researchers still don鈥檛 fully understand why some people develop keratoconus. In most cases, it develops for no apparent reason. It鈥檚 generally thought that both environmental and genetic factors play a role in its development.

• Family history. It鈥檚 thought that some people with keratoconus may carry genes that make them predisposed to its development if they鈥檙e exposed to certain environmental factors.
• Underlying disorders. Keratoconus sometimes occurs in the presence of certain underlying disorders, but a direct cause and effect hasn鈥檛 been established. These disorders include Down syndrome, sleep apnea, asthma, some connective tissue disorders including Marfan syndrome and brittle cornea syndrome, and Leber congenital amaurosis.
• Environmental risk factors. Some environmental risk factors may contribute to the development of keratoconus including excessive eye rubbing and wearing contacts.

How is keratoconus diagnosed?

To make a keratoconus diagnosis, your eye doctor with give you a thorough eye exam and examine your medical and family history.

During the eye exam, your eye doctor may examine:

• the overall appearance of your eyes
• your visual acuity
• your visual field
• your eye movements

You may also undergo a slit lamp exam where your doctor examines your eye with a special light under high magnification. Diagnosis of keratoconus may also involve a specific imaging test called corneal topography to allow your doctor to examine changes to your eye that aren鈥檛 otherwise visible. Corneal topography creates a three-dimensional image of the surface of your cornea.

What is the treatment for keratoconus?

Treatment of keratoconus focuses on maintaining your visual acuity and stopping changes to the shape of your cornea. Treatment options vary based on the severity of the condition and how fast it鈥檚 progressing.

Prescription contacts or glasses

Prescription glasses or soft contact lenses can be used to improve visual acuity in mild cases of keratoconus. Due to progressive changes to your cornea, you may require frequent prescription changes.

Surgery

Some people with keratoconus don鈥檛 tolerate contact lenses well due to discomfort, severe corneal thinning, or scarring. If your vision can鈥檛 be corrected with lenses, you may require corneal transplant or keratoplasty. This surgery involves replacing your corneal tissue with tissue from a donor. It鈥檚 usually only used in severe cases.

Corneal cross-linking device (CXL)

Corneal cross-linking聽(CXL) is a treatment for patients with keratoconus or post-LASIK ectasia (bulging of the cornea after聽LASIK surgery). It is successful in over 90% of cases and can prevent their condition from getting worse. Although approved and used in Europe since 2003, it was not FDA approved in the US until April 2016.

What are the risk factors for developing keratoconus?

Risk factors for developing keratoconus include:

• Family history. About 10 to 20 percent of people with keratoconus have a family history.
• Childhood eye-rubbing. Excessive childhood eye rubbing is thought to increase your risk by 25 times.
• Close genetics relation between parents. Having a close genetic relationship between parents is thought to increase your risk of developing keratoconus by about 3 times.
• Race. Studies suggest that keratoconus rates are higher in people who are Asian compared to people who are Caucasian.
• Atopy. It鈥檚 been suggested that atopy may be associated with the development of keratoconus, possibly due to increased eye rubbing due to eye irritation. Atopy is the genetic tendency to develop allergic diseases such as eczema, asthma, or allergic rhinitis.

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