The cornea is the clear dome on the front of the eye, and it is composed of several different layers. The outermost layer is the epithelium, and it is the layer most often involved in problems such as scratches and dryness. One of the results of dry eyes is Superficial Punctate Keratitis, or SPK. This occurs when the epithelial cells are damaged by exposure to the elements or a lack of lubrication. Corneal abrasions are simply scratches on the surface of the eye, which can be extremely painful and cause blurred vision. Corneal injuries due to trauma should be evaluated in the office to determine whether medical treatment is necessary. The inner layers of the cornea are most likely to be affected by diseases that are genetic, such as Keratoconus or Fuch's Dystrophy. Anterior Basement Membrane Dystrophy (AMBD) is another genetic corneal disease. These conditions cannot be prevented, but can be managed medically to maximize vision and increase patient comfort.
Keratoconus- This condition results in progressive thinning of the cornea, resulting in a cone shape that sometimes causes high amounts of and/or irregular astigmatism, corneal scarring, and corneal edema. Keratoconus is managed by correcting the vision with glasses or gas-permeable contacts, if possible, or sometimes by surgical correction if the vision is not correctable by other means. Some cases of advanced keratoconus may be cause for considering a corneal transplant.