Cornea Treatment Options in Delhi
The cornea, the outermost layer of the eye, is a crucial component that enables vision by allowing light to enter the eye.
It contributes to around 70 percent of the eye's focusing power, making it vital to maintain corneal health.
Refractive problems like myopia, hyperopia, and astigmatism can arise due to changes in the cornea's shape.
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Structure of the Cornea
The cornea consists of five distinct layers, each with its own functions:
1. Epithelium – Guardian of Eye Health
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The outermost layer is the epithelium, comprised of regenerative cells that continuously shed and regenerate.
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Functions: Protects the eye from dust, debris, and impurities while absorbing essential nutrients and oxygen from tears.
2. Bowman's Layer – Defender of the Eye
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Bowman's layer, also known as the anterior limiting membrane, is a sturdy layer of collagen fibers located between the epithelium and the corneal stroma.
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Functions: Protects the corneal stroma.
3. Stroma – Clarity Contributor
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The middle layer of the cornea, the stroma, constitutes about 90 percent of its thickness.
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Composition: Comprised mainly of collagen fibrils, water, and interconnected keratocytes.
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Functions: Ensures the cornea's transparency.
4. Descemet's Membrane – Infection Shield
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Descemet's membrane, or the posterior limiting membrane, is the fourth layer and provides protection against infections and injuries.
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Composition: Composed of collagen fibrils.
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Location: Separates the stroma from the corneal endothelium.
5. Endothelium – Fluid Regulator
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The innermost layer, the endothelium, consists of mitochondria-rich cells and maintains a balance of fluids within the cornea.
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Function: Regulates the flow of fluids between the cornea and the eye's interior.
Keratoconus – A Common Corneal Problem
Keratoconus is a progressive eye disease in which the cornea thins and assumes a conical shape, leading to irregular refraction of light and causing blurred, distorted vision and high astigmatic errors. It often affects both eyes, typically starting during puberty and progressing most rapidly in young individuals. It can be an isolated sporadic disorder or result from constant eye rubbing in response to allergic eye conditions in childhood.
Symptoms of Keratoconus
The symptoms of keratoconus vary depending on the disease's stage:
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In early stages, patients may experience frequent changes in their eyeglass prescription, increased astigmatism, and an inability to achieve 20/20 vision with corrective lenses.
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Advanced cases are characterized by significant image distortion and profound visual impairment.
Diagnosis of Keratoconus
Keratoconus can be detected through keratometry, but corneal topography (Scheimpflug technology-Pentacam) has become essential for its management. Anterior Segment Optical Coherence Tomography (ASOCT) has also largely replaced ultrasonic pachymetry for measuring corneal thickness and epithelium.
Treatment of Keratoconus
Step 1 – Halt Disease Progression
Corneal Cross-Linking (C3R or CXL): This non-surgical procedure strengthens the cornea using riboflavin drops and controlled ultraviolet radiation, effectively halting the progression of keratoconus. Different techniques are employed based on corneal thickness.
Step 2 – Vision Rehabilitation
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Spectacles & Contact Lenses: Spectacles are suitable for mild keratoconus, but many patients prefer contact lenses for improved visual acuity. Options include Rigid Gas Permeable (RGP) lenses, hybrid lenses, Rose-K lenses, mini-scleral, and scleral lenses.
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Surgical Intervention: Surgical options include Intrastromal Corneal Ring Segments (INTACS) to regularize corneal surface, Topography-guided Custom Ablation Treatment (T-CAT) using excimer laser, Phakic Intraocular Lenses (ICLs) for permanent correction, and Keratoplasty (corneal transplantation) for severe cases. The choice of procedure depends on the patient's condition.
Conclusion
The health and function of the cornea are critical for maintaining good vision. Keratoconus, a common corneal disorder, can be managed effectively through a combination of treatments tailored to the individual's condition and needs. If you suspect any issues with your cornea, it is essential to consult an eye specialist for proper diagnosis and treatment in Delhi.