Corneal opacity

The Corneal opacity is a disease of the cornea which occurs comparatively frequently. Nevertheless, it is relatively unknown, which is due to the numerous causes. Treatment is also difficult.

What is corneal opacity?

Corneal opacity is understood as a reduced transparency of the cornea. The clinical picture usually arises from pathological or degenerative changes in the cornea and is often associated with a noticeable discoloration of the outermost layer.

causes

Corneal opacity can be triggered by a number of things. Most often it is caused by scars or swellings on the cornea caused by ulcers or injuries. If the cornea swells, liquid penetrates into it and slowly becomes cloudy. This reduces eyesight and permanently changes the color of the cornea. In addition, hereditary metabolic disorders such as stromal corneal dystrophy can cause corneal opacity.

Injuries to the eye and especially to the cornea are generally a common cause of cloudiness. In particular, if there is thickening that is not treated, the effect can persist permanently. Finally, clouding of the cornea can also be caused by an infection with herpes viruses. These get into the eye through foreign objects such as contact lenses. Eye diseases such as keratoconus also cause corneal opacity.

Symptoms, ailments & signs

Corneal opacity is initially expressed as a decrease in visual acuity. Those affected first perceive poor eyesight, which can manifest itself, among other things, in a clouding of the field of vision and excessive sensitivity to light. Those affected usually notice a kind of foreign body sensation in the eye, which increases in the course of the disease and is perceived as very unpleasant.

Small vesicles can form in the cornea that are painful to touch. If the vesicles open, severe pain occurs and there is a risk of acute eye infection. In the further course, corneal ulcers can form. If the corneal opacity is not adequately treated, the visual problems increase and eventually complete blindness occurs.

Before that, images are increasingly blurred and distorted; the cloudiness often leads to falls or accidents in everyday life. Externally, corneal opacity appears as white discolorations that form a film on the cornea and heavily cloud the affected eye. The discoloration intensifies as the disease progresses and ultimately affects the entire eye. Sometimes the edges of the eyes are reddened or there is visible cornification in the area of ​​the eyelids.

Diagnosis & course

Schematic representation of the anatomy of the eye with myopia and after treatment. Click to enlarge.

The corneal opacity can usually be diagnosed by those affected. It does this based on various symptoms, such as decreased eyesight and excessive sensitivity to light.

In addition, small bubbles can appear on the surface of the cornea. This is the case, for example, with untreated injuries. If one or more of the symptoms mentioned is present, a visit to the ophthalmologist is recommended. This can narrow down the possible diseases in conversation with the person concerned and make the diagnosis on the basis of various examinations.

An eye test and a detailed examination of the cornea with the help of a so-called slit lamp are important components of the examination. The exact diagnosis can be made if these examinations reveal white-gray discoloration in the area of ​​the cornea. Thickening is also a clear sign.

The course of corneal opacity is similar in most cases. At first, the person concerned only perceives minor cloudiness and sees images distorted and blurred. If the cloudiness is then not treated, the affected person perceives less and less and ultimately becomes completely blind. This process can take years. It can also be that the cloudiness does not progress any further after a certain point, the restrictions in daily life are nevertheless considerable.

Complications

Corneal opacity that is not very advanced can often be treated conservatively. This treatment involves fitting a hard contact lens with which a refractive error can be corrected. However, if the current situation is not stabilized with this lens, a corneal transplant may be necessary.

Corneal inflammation, which must be treated with antibiotics and anti-inflammatory drugs with appropriate medication, can either be accompanying or not ruled out. There is a risk that structures in or on the eye will be damaged. Inflammation as well as healing disorders or scarring cannot be ruled out. Bleeding and inflammation of the retina can occur, but fortunately they are classified as very rare.

There is also the risk of renewed corneal opacity. This would result in another operation. In rare cases, retinal damage or allergic reactions occur. An ametropia that sometimes occurs or a change in the refractive power values ​​can usually be compensated for with glasses or contact lenses, so that the complication usually does not lead to serious restrictions. In extremely rare cases, blindness or loss of the operated eye occurs.

When should you go to the doctor?

You should always see an ophthalmologist if symptoms such as extreme sensitivity to light occur, possibly in combination with deterioration in vision and pain in the eye. If corneal opacity is detected early enough, the chances of treatment are good. This is why it is important to see a doctor as soon as the first symptoms appear. Risk groups include wearers of contact lenses, people who have had corneal injuries or ulcers in the past and people with a history of herpes infection.

Those affected should have the symptoms examined at the first indication of corneal opacity. It makes sense to record them in a diary. These records are helpful to the doctor. If the corneal opacity is based on a hereditary predisposition, doctors try to carry out preventive treatment. Corneal opacity must be treated by a doctor, otherwise irreparable damage to the eye can occur, and in the worst case there is a risk of blindness.

Doctors & therapists in your area

Treatment & Therapy

Corneal opacity cannot be remedied by conventional therapy methods. The only way to effectively treat the opacity is to transplant a donor cornea. These are assigned via special corneal banks, for which there are long waiting lists. However, they can also be used immediately in an emergency such as an accident or worsening of the corneal condition.

Smaller scars or cloudiness can be eliminated with the help of modern treatment methods at least to the extent that the person concerned no longer has any difficulties in everyday life. Usually a laser is used for this. In this form of treatment, known as phototherapeutic keratectomy (PTK), the hardened tissue that leads to the clouding is carefully removed and the clouding is removed.

Since the procedure is risky, it is only an option if it is really necessary. If surgery is required, general anesthesia or local anesthesia will be performed depending on the situation. The surgeon removes the diseased cornea with the aid of a surgical microscope and then sews the donor cornea onto the eye. After the operation, the patient must also use antibiotics, ointments and other preparations to prevent inflammation. After a year, the sutures are finally removed and the patient has full eyesight again.

You can find your medication here

➔ Medicines for visual disturbances and eye complaints

Outlook & forecast

If the corneal opacity is triggered by swelling in the eye after a fall or accident, the patient usually makes a full recovery as soon as the swelling has healed. The prerequisite for this is that no permanent damage or irreparable damage has occurred.

In the case of a scar in the cornea or a metabolic disease in the patient, an individual analysis of the state of health must decide which steps are possible to improve health. Smaller scars can be treated with modern therapy methods. Often a significant alleviation of the symptoms or freedom from symptoms is possible.

In the case of larger scars or damage, the prognosis is unfavorable. There is no improvement in vision without surgery. A transplant is necessary so that there is a chance of relief from the symptoms. To do this, a donor's cornea is transplanted into the patient's eye. If the operation is successful, full recovery can occur. The transplanted cornea takes over all functions of the removed tissue.

If complications arise or if the new cornea is rejected by the organism, the chances of a cure decrease drastically. A new transplant may possibly take place after a while. However, there are long waiting lists and a guarantee of success in the event of a new intervention cannot be given in advance.

prevention

Corneal opacity can be prevented in several ways. The risk is already minimized by not wearing contact lenses, as these can cause infections in the eye. In general, one should try to handle the eyes carefully and avoid injuries and inflammation.

If foreign bodies get into the eye, a doctor should be consulted as soon as possible in order to avoid corneal clouding. An ophthalmologist should also be consulted if eyesight is impaired or other visual problems occur. The disease usually progresses insidiously, which is why those affected usually only recognize it when it is already too late.

Corneal opacity, which is hereditary, is difficult to prevent. However, the severity of the disease can be curbed by early treatment. The same applies if the corneal opacity is due to a disease.

Aftercare

In the case of corneal opacity, follow-up measures prove to be relatively difficult in most cases, as complete healing cannot always be achieved. The earlier the disease is diagnosed and treated, the better the further course is usually, so that the patient should contact a doctor as soon as the first symptoms of this disease appear.

In most cases, the disease can only be completely cured if a donor cornea is present and this can also be transplanted. This procedure is usually carried out under general anesthesia and without complications. After the procedure, the affected person has to protect his eyes and not expose them to strong eyesight. The affected eye will then become accustomed to normal eyesight over time.

In addition, it is often necessary to take antibiotics to prevent inflammation. The person concerned should pay attention to the correct dosage and also to the regular intake of these drugs. They should also not be taken with alcohol. Since the corneal opacity can also lead to psychological upsets or depression, intensive and loving conversations with your own family or friends are very useful.

You can do that yourself

Since corneal opacity manifests itself differently in each patient, the options for self-help in everyday life vary considerably.

If the cornea is slightly cloudy and there is still the possibility of regression, patients take special precautionary measures to protect the eyes. So it is important to protect the diseased eye from overexertion. Such overloads come about, for example, from strenuous and prolonged staring at various screens, for example when working on a computer or watching television. In addition, the eye must also be protected from stress caused by the weather, such as wind and direct sunlight. If applied indoors, too bright light should also be avoided. Patients with corneal opacity initially forego contact lenses as long as the doctor does not give their express consent. Meticulous eye hygiene protects the eye from infections that may worsen corneal opacity.

In the case of pronounced corneal opacity with considerable impairment of vision, it is important for those affected to come to terms with the situation and, as far as possible, to take adequate precautionary measures. This is especially true at home, where changes to the furnishings or stronger color contrasts can improve orientation. Therapeutic offers support the patient in exercising his other senses more effectively.