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Corneal Diseases

Ocular Allergies

Allergies affecting the eye are fairly common in San Antonio. The most common allergies are those related to pollen (oak & cedar) or mold, particularly when the weather is hot and dry.

Symptoms of ocular allergy include redness, itching, tearing, burning, stinging, and watery discharge. Antihistamine decongestant eyedrops can reduce these symptoms, as does rain and cooler weather, which decreases the amount of pollen in the air.

In addition to pollen and mold, ocular allergy cases are related to medications, contact lens wear, animal hair, and cosmetics. Touching or rubbing your eyes after handling nail polish, soaps, or chemicals may cause an allergic reaction. Allergy symptoms are temporary and can be eliminated by not having contact with the offending agent.

Conjunctivitis (Pink Eye)

Conjunctivitis describes swelling, itching, burning, and redness of the conjunctiva, the protective membrane that lines the eyelids and covers exposed areas of the sclera, or white of the eye.

Conjunctivitis can be contagious and affects millions of Americans at any given time. Conjunctivitis can be caused by viral or bacterial infection, allergy, environmental irritants, contact lens product, eye drops, or eye ointments.

Initially, conjunctivitis is usually painless and does not adversely affect vision. In most cases, the infection will clear without requiring medical care. However, some forms of conjunctivitis require treatment. In these cases, If treatment is not obtained in a timely fashion, the infection may worsen and cause corneal inflammation and possibly loss of vision.

 

Corneal Ulcers

Minor trauma to the cornea can cause painful inflammation and corneal infections. These infections can reduce visual clarity, produce corneal discharges, and erode the cornea.

Corneal infections occur infrequently, but are the most serious complication of contact lens wear.

Minor corneal infections are typically treated with anti-bacterial eye drops. If the problem is severe, it may require more intensive antibiotic treatment or treatment with multiple, fortified antibiotics. When fungi are detected, anti-fungal treatment may be necessary. Frequent visits to an ophthalmologist may be necessary for several weeks to months to eliminate the problem.

 

Dry Eye

Dry eyes occur when your tears aren’t able to provide adequate moisture for your eyes. Tears can be inadequate for many reasons.

Dry eyes can be very uncomfortable. If you have dry eyes, your eyes may sting, burn, get red and even tear. You may experience dry eyes in certain situations, such as on an airplane, in an air-conditioned room, while reading, or after looking at a computer screen for a few hours. This problem can be exacerbated by use of a ceiling fan.

Dry eyes treatments may make you more comfortable. Treatments include lifestyle changes (i.e. turning off ceiling fans) and artificial tear eye drops or Restasis®. In some cases, plugging the tear ducts with punctal plugs may be beneficial.

 

Fuchs’ Corneal Dystrophy

Fuchs’ Dystrophy patients can awaken with blurred vision that will gradually clear during the day. As the disease worsens, this swelling may remain constant and reduce vision throughout the day.

Fuchs’ dystrophy occurs when endothelial cells begin to die (some cases are genetic). As more endothelial cells are lost, the endothelium becomes less efficient at pumping water out of the stroma. This causes the cornea to swell, blurs the vision and can even cause pain.

Treatment aims to reduce the swelling with drops, ointments, or soft contact lenses. A hair dryer held at arm’s length or directed across the face may be useful to clear the cornea. When the disease becomes more severe and interferes with daily activities, a corneal transplant may be required.

 

Ocular Herpes

The herpes virus can cause inflammation and scarring of the cornea that sometimes is referred to as a cold sore on the eye.

Ocular herpes is transmitted through contact with another person who is having an outbreak, or through self contact and contamination during an active herpes infection (such as a cold sore of the lip). The herpes simplex virus enters the body through the nose or mouth and travels into the nerves, where it may be inactive. The virus can remain dormant for years and may never wake up. The exact cause of an outbreak is unknown, but stress-related factors such as fever, sunburn, major dental or surgical procedures and trauma are often associated with incidents.

Treatment of ocular herpes typically involve topical eye drops/gels or oral acyclovir. In some cases, steroid drops may be necessary. Long-term use of oral medication may be required to prevent outbreaks.

 

Map-Dot-Fingerprint

Map-dot-fingerprint dystrophy, which tends to occur in both eyes, usually affects adults between the ages of 40 and 70, although it can develop earlier in life.

Also known as epithelial basement membrane dystrophy, map-dot-fingerprint dystrophy gets its name from the unusual appearance of the cornea during an eye examination.

Treatment may involve patching the eye to immobilize it or the use of lubricating eye drops and ointments. With treatment, these erosions usually heal within few days, although periodic flashes of pain may occur for several weeks thereafter. More aggressive treatments include anterior corneal punctures to allow better adherence of cells, corneal scraping to remove eroded areas and allow regeneration of healthy epithelial cells, and use of the excimer laser to remove surface irregularities.

 

Pterygium

Pterygia are more common in sunny climates and in the 20-40 age group. Scientists do not know what causes pterygia to develop.

Doctors believe ultraviolet (UV) light from the sun may be a factor. While some studies report a higher prevalence of pterygia in men than in women, this may reflect different rates of exposure to UV light.

Many people want to have a pterygium removed for cosmetic reasons. Surgery is not recommended unless your vision is affected. Pterygium can reoccur. Artificial tears and mild steroids can be used to calm inflammed pterygia.