Cornea Treatment


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So many over-the-counter medications, like allergy eyedrops, oral antihistamines, & nasal corticosteroids will be used as directed for the ocular allergies. Some most commonly used options include:

♦ Eyedrops
♦ Ketotifen (Zaditor)
♦ Oral antihistamines
♦ Loratadine (Claritin)
♦ Cetirizine (Zyrtec)
♦ Fexofenadine (Allegra)
♦ Diphenhydramine (Benadryl)
♦ Nasal steroids
♦ Triamcinolone (Nasacort)
♦ Fluticasone (Flonase)

In addition, many prescription medications are also available to help reduce allergies.

Prescription of eyedrops are generally very effective and safe, since they are applied topically and have few if any systemic side effects. Most eyedrops can be used once to twice daily and help not only with relieving symptoms but can also prevent symptoms. Some common allergy eyedrops include

♦ Nedocromil (Alocril),
♦ Olopatadine (Patanol),
♦ Azelastine (Optivar),
♦ Pemirolast (Alamast),
♦ Epinastine (Elestat)

Allergen immunotherapy (allergy shots) is also an excellent treatment option for allergic conjunctivitis. If this is appropriate, an individual is seen by an allergist and completes testing for common airborne allergens. Based on the results, an allergist can prescribe immunotherapy that can not only improve symptoms but may also help get rid of existing allergies and also prevent future environmental allergies.

Historically, immunotherapy requires frequent visits to the allergist for subcutaneous injections. Sublingual immunotherapy (allergy tablets) can be administered at home for grass and ragweed allergy. Although immunotherapy is effective and safe, there is a small risk of allergic reaction (roughly 0.1%)
There are various options to treat keratoconus, which includes:
♦ Spectacles/glasses
♦ Contact lenses
♦ Corneal implants & corneal transplants.

In the initial stages of keratoconus, glasses are generally successful in treating and correcting the myopia and astigmatism, since the condition advances the cornea will becomes highly irregular & vision is no longer sufficient to correct with the help of glasses.

Contact lenses are used to maintain the regular shape of cornea, yet in 5 – 10% of patients there will comes a stage when the contact lenses are no longer efficient and a corneal transplant need to be considered and performed. Contact lenses won’t slow down the rate of progression of conical cornea, still they do give a good vision at that period which could not otherwise been achieved.

Corneal transplants is having a very high successful rate following the transplantation, with 98.1% of transplanted corneas are surviving in the first year, & 97.5% are surviving beyond 4 years. Corneal transplant surgery generally takes about an hour & is done under a general or local anaesthetic. Fine instruments were used to remove the affected cornea and then replaced with a clear donor cornea.

Fine nylon stitches are done to suture the graft into place. In the case of the endothelial keratoplasty, to attach the graft into place an air bubble is been used. Most of the patients can go home on the day of the surgery, but even though some patients may require an overnight stay.

A thorough examination with ophthalmologist will help to establish which treatment is suitable and best for your individual case.

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Blepharitis is an inflammation which is caused to the eyelids, usually caused by an excess growth of the bacteria that is usually seen on the skin, blockage of the eyelids oil glands & rarely allergies.

Blepharitis is a common eye condition, which causes the eyelids to reddened, itchy, & somewhat swollen & scaly-appearing at the base of eyelashes. It is the most frequent cause of dry eyes. A dysfunction of the eyelids oil glands which leads to blepharitis occurs due to a hormone imbalance.

Self-care measures, like washing the eyes & using warm compresses, will be the only treatment required for most cases of the blepharitis. If that is not enough, doctor suggest you prescription treatments, which includes: Medications that fight infection: Antibiotics that apply on the eyelid have been shown to give relief of the symptoms & decrease bacterial infection of the eyelids. These are available in variety of forms, like eyedrops, creams & ointments. If you dont react to the topical antibiotics, doctor may suggest you an oral antibiotic.

Medications to control inflammation: Steroid eyedrops or ointments which may help you to control inflammation. Your doctor prescribes both antibiotic & anti-inflammatory drugs.

Medications that affect the immune system: Topical cyclosporine (Restasis) is a calcineurin inhibitor which has been shown to give relief of some signs & symptoms of blepharitis.

Treatments for underlying conditions: Blepharitis is caused by seborrheic dermatitis, rosacea or other type of diseases may be controlled by treating the primary disease. Blepharitis occasionally disappears completely. Even with a successful treatment, the condition usually is chronic & requires daily attention with the eyelid scrubs. If you dont respond to the treatment, or if you have also loss eyelashes or only one eye which is been affected, the condition can be caused by the localized eyelid cancer.

Chemical eye burns may occur when the eye comes into contact with a liquid, solid or vaporous chemical. The severity of the burn is based on chemicals, as well as the amount which comes into contact with the eye. Luckily, the vast majority of the burns are treatable & cause only temporary discomfort. Chemical eye burns fall into 3 categories depends upon the acidic or alkaline level, measured in pH. The pH scale ranges from 0-14 & indicates how much acidic or basic substance is present. The pH of 7 is neutral and the pH of healthy tears is 7.5. A pH which is less than 7 is acidic while a pH which is greater than 7 is basic. Mild chemical eye burns that can treat quickly and usually heals within few days. Eye care: You eye will be rinsed by your caregiver. Then he removes any remaining chemicals or other objects from the eye. He may give you the artificial tears or an eye patch to protect the eye & help to heal it.
Medicines: Antibiotic medicine: This will help to prevent the infection which is caused by bacteria. It may be given as an ointment or eyedrop.

Pain medicine: You will be given medicine to take away or decrease the pain. Do not wait till the pain is severe before you take the medicine. This medicine will be given as a pill or eyedrop.

Cycloplegic medicine: This medicine dilates the pupil & relaxes your eye muscles to help in decrease the pain & twitching.

Steroids: This medicine will be given to decrease the inflammation.

Debridement: Caregivers will remove any of the damaged tissue from your eye to reduce the inflammation & help your eye to heal.

Tenoplasty: Caregivers rebuild the damaged parts of the eyeball & restore the surface of the eye.

Tissue grafting: Caregivers may replace a damaged tissue in your eye.

Transplant: Caregivers will replace the damaged cornea or other parts of the eye.

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Refractive errors can be corrected by using eyeglasses, contact lenses, or surgery. Eyeglasses are the simplest & safest way to correct the refractive errors. Your doctor will prescribe appropriate lenses to correct the refractive error & give you the optimal vision.

Contact Lenses will works as the first refractive surface of the light rays which are entering the eye, giving a more precise refraction or focus. In so many cases, contact lenses will provide a clearer vision, a wider field of vision & greater comfort. These are safe & effective option if fitted & used properly. It is very important to wash the hands & clean your lenses as instructed in order to decrease the risk of infection.

Refractive Surgery main motto is to change the shape of cornea everlastingly. This will change the eye shape that restores the focusing power of eye by allowing the light rays to focus accurately on the retina for an improved vision. There are various types of refractive surgeries. Your eye care doctor will help you to decide if the surgery is an option for you.

Excimer laser correct the refractive error

The effect of excimer laser to correct the refractive error on cornea is very same as grinding of the glass lens to change the refractive power. In person’s eyes who are with the refractive errors, excimer laser can be used due to its high level of precision, it will alter the shape of cornea to change the refractive power to a desired state & thus correcting the refractive error.

In myopia, the central part of cornea is made as flatter, & so decreasing the refractive power of the cornea & the eye, and hence correcting the refractive error.

Likewise in hypermetropia, the laser will removes a ring of the tissue from the peripheral part of cornea & hence make the central part steeper & corrects the refractive error.

In astigmatism, excimer laser will correct by selectively ablating the cornea in specific required direction.

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A corneoscleral laceration usually a result of some injury. All attempts to repair a corneoscleral laceration will be done in the operating theater by using an operating microscope by trained ophthalmic personnel.

♦ Repair of a corneoscleral tear includes suturing the cornea, sclera (white part of the eye) and restoring the eyes’ original anatomy.

♦ For repairing the laceration, your doctor will first estimate the severity of the damage, administer anesthesia and then if needed, suture the globe prior to exploring the wound.

♦ Your doctor will suture the limbus (border of cornea and sclera), and perform the technique to treat the prolapsed iris or vitreous (gelatinous mass which fills the space in between the lens and back of the eye) if necessary.

♦ Your doctor will then explore the scleral wound and repair the segments of scleral lacerations.

♦ The whole procedure is completed by injecting the antibiotics into the eye, suturing the conjunctiva (scleral covering) and by applying an eye patch.

The first step in penetrating keratoplasty is the preparation of donor tissue. The corneal button should be cut 0.25-0.50mm larger than the diameter of the host corneal opening, as it will help to reduce the excessive postoperative corneal flattening, decrease the risk of secondary glaucoma & enhances the wound closure.

The host cornea is trephined, the anterior chamber is been filled with the viscoelastic & the donor tissue is positioned endothellial side down on the recipients eye. The cornea is then sutured in a place with either the continuous or interrupted sutures. Interrupted sutures are been chosen in thinned, vascularized or inflammed corneas also in the pediatric cases.

Penetrating keratoplasty can be combined with the intraocular lens implantation, cataract surgery, secondary, glaucoma surgery & retinal surgery.

PK has the ability to treat disease in the epithelial, stromal & endothelial layers. A full-thickness graft also eliminates the optical interface which is related to visual problems that exist with the lamellar transplants with stroma-stroma interface.

Even though, the postoperative recovery time is comparatively long, sometimes it may take some years to achieve best-corrected visual acuity.

Corneal sculpting surgeries have been about for almost a century, but with the advent of excimer laser, these types of corneal surgeries are been a popular option for the people who are looking to correct myopia, hyperopia & astigmatism. Even though these types of corneal surgeries are safe & effective, there is much to learn about how the cornea will reacts & heals after performing these types of surgeries, and how best these surgeries will drive the lasers to give an optimal vision for the patients.

Usually refractive corneal surgery helps to improve your vision. This surgery with the help of a laser will reshape your cornea. It rectifies a mild-to-moderate farsightedness, nearsightedness & astigmatism. Then you will be less dependent on the glasses or contact lenses after the surgery is done. Sometimes, you won’t need glasses also. The total time taken for the surgery is 30 minutes.

You will have a shield on your eye when you return home after the surgery. This will keep you from putting pressure on eyes or rubbing the eye. It will also been protect your eye from being poked or hit.

After surgery, you may have:

Mild pain, scratchy or burning feeling, tearing, light sensitivity, & hazy or blurred vision on the first day or so. After PRK, these symptoms will last after few days.

Red or bloodshot appears on the whites of the eyes. This will be last for 3 weeks after the surgery.
Dry eyes will be till 3 months.

Steps to take for recover, such as:
Take a few days off from the work after the surgery till most of the symptoms get better.
Avoid all noncontact activities like bicycling & working out at the gym at least 3 days after the surgery was done.
Avoid contact sports like boxing & football for the first 4 weeks after the surgery.

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