Dry eyes can result either from a reduced tear production from the tear glands or excessive evaporation of the tears from the eye. Inflammation of the eyelids (blepharitis) or prolonged exposure of the eyes to dry, cool surroundings, is the most common culprit. It is also seen in the elderly, with history of diabetes, arthritis, and those on certain long term medications. Most of the patients with “Dry eyes” complain of burning, stinging, itching, gritty sensation in the eyes, dryness, soreness, heaviness of the lids, light sensitivity and/or “tiredness of the eyes”. Symptoms are often worse at the end of the day and can be aggravated by certain activities (e.g. reading, watching television, and working on the computer) and certain surroundings (e.g. airplane cabins, air conditioned rooms, smoky rooms.) Treatment of dry eye involves multiple modalities including lubricants, tear stimulation, punctual occlusion etc. The latest advancement in dry eye management is the advent of lipiflow which gives a controlled heat and pressure over the lids to help to remove the blocks and increase the flow from the glands in the lids.
A pterygium is a growth of tissue onto the surface of the cornea, often a result of prolonged sun exposure (UV rays). It commonly causes redness, irritation and if large enough, even decreases vision. A pterygium causing too many symptoms requires surgical removal. Pterygium excision is a simple 10 minute day care procedure. After removing the pterygium, a conjunctival graft is placed in the bare area which can be held in place by using just surgical glue without the need for any sutures! This graft prevents recurrence of pterygium after it has been excised.
Keratoconus is progressive condition characterized by weakening of the cornea wherein the cornea (the outer clear part of the eye) becomes “cone-shaped”, instead of being spherical. It is said to happen when the corneas are less “rigid”. Keratoconus typically develops between the ages of 12 and 25 years and results in progressive reduction in vision. Early cases can be treated with rigid contact lenses, while those who can’t tolerate contact lenses at all, may require a corneal transplant. Recently, a technique to arrest its progression has also been introduced. Corneal collagen cross-linking of the cornea with Riboflavin (C3R) is available to increase the rigidity of the cornea thus arresting its progression.
Corneal scars are usually formed following trauma or corneal infections and if it is dense enough can cause obscuration of vision. Depending on the density, location and thickness of scar, either a laser or corneal transplantation can be performed to remove the scar and restore vision.
These are hereditary group of disorders that can cause opacification of the cornea and progressive decline in vision. If a family member has this disorder, it is advisable that the close relatives get screened for this disorder by a simple ophthalmic examination. Corneal dystrophies can be successfully managed using lamellar corneal transplantation.
Corneal infections occur usually following trauma and can be bacterial, fungal or viral infections. They present with sudden onset of pain, redness and decline in vision. These infections need to be diagnosed and treated early. Samples are taken and a detailed microbiological work up is done. Milder infections can be treated with drops and more severe infections may require a therapeutic keratoplasty.
A number of ocular surface disorders like ocular Steven Johnson syndrome, Chemical injuries, Ocular Cicatricial Pemphigoid & Neurotrophic Corneas require very specialized care. At the Eye Foundation we offer the entire gamut of complicated procedures for treating these difficult set of disorders ranging from Limbal stem cell transplantation, Amniotic membrane transplantation, Mucous membrane grafts and in some extreme cases replacing the entire cornea with an artificial carrier called Keratoprosthesis. Ocular Surface disease require urgent intervention and early diagnosis and treatment are necessary for restoration of vision.
Pentacam Tomography – the latest and most advanced three dimensional tomographer which accurately images the cornea and screens patients for Lasik and Keratoconus.