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Corneal Opacities: Eye Disorders That Can Cause Vision Loss

Corneal Infection continued...

Contact lens-related infection. Most people wear contact lenses without any problems. However, the cornea can become infected with bacteria, viruses, fungus, and microbes due to improper use or cleaning of contacts.

Herpes zoster (shingles). This infection is caused by the same virus that causes chickenpox. In some people, the infection becomes active again later in life, causing a painful, blistering rash called shingles. Shingles that develop on the face, head, or neck can also affect the cornea. Forty percent of people who get shingles in those areas will develop it on the cornea.   

Ocular herpes. Herpes of the eye is caused by the herpes simplex virus, the same virus that causes oral and genital herpes. Ocular herpes develops on the eyelid or surface of the eye and can lead to corneal inflammation. This virus is the most common eye infection that causes blindness in the U.S.   

Depending on the cause, treatment for corneal infections may include:

  • Antibiotic, antibacterial, antifungal, or steroidal eye drops
  • Topical or oral antiviral medication
  • Phototherapeutic keratectomy (laser surgery)
  • Corneal transplant

Corneal Dystrophies

Corneal dystrophies are somewhat rare conditions that cause changes to the cornea. There are more than 20 corneal dystrophies. These eye problems are inherited. If someone in your family has one of these eye conditions, you may be at risk.

Corneal dystrophies usually affect both eyes and can cause vision loss and blindness. Sometimes they cause no symptoms and are only discovered during an eye exam. Here are a few of the more common types of corneal dystrophies:

Fuchs' dystrophy progresses slowly, usually affecting people in their 50s and 60s. The condition damages the endothelial cells in the cornea. Symptoms include swelling and blistering of the cornea, blurred vision, pain, and vision problems. Early on, drops, ointments, and special contact lenses may ease symptoms. At later stages, corneal transplants successfully restore vision.

Map-dot-fingerprint dystrophy causes small gaps between the outer layer and the rest of the cornea, called epithelial erosions. These gaps cause blurred vision, pain, and other symptoms that often flare up between ages 40 and 70. Usually the symptoms go away on their own without causing vision loss. Many people don't even know they have map-dot-fingerprint dystrophy. When symptoms occur, treatment may include eye drops and ointments, patching the eye, and removing eroded parts of the cornea.         

Keratoconus is a progressive thinning of the cornea that affects 1 in 500  people in the U.S., usually in their teens and 20s, but it can occur in nearly every decade of life. With keratoconus, the cornea becomes thin and bulges outward in a cone shape, like a hernia. The condition can cause moderate to severe blurred vision, multiple images, glare, and halos around objects at night and rob people of the ability to lead a normal life. Often nearsightedness and astigmatism develop from keratoconus. Other symptoms include swelling and scarring of the cornea. In mild cases most people can manage the condition with eyeglasses or special contact lenses. In moderate to severe cases. corneal crosslinking  a procedure that uses riboflavin and light to strengthen the cornea is generally recommended to prevent further worsening of disease.   Procedures such as intacs can help improve vision by partially reversing keratoconus. Corneal transplant, a surgery that replaces the cornea with a cadaver cornea, may be an option. Often contact lenses and glasses are required afterwards to improve sight.

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