Cornea specialist in Santacruz,Mumbai

Clear Vision Eye Centre is headed by the most trusted cornea specialist in Santacruz, Mumbai, who employs the most advanced tools and techniques to provide the most effective cornea treatment.

What Is Cornea?

The corneal is the most vital part of the eye as it performs the two primary functions:

  • It covers and protects the pupil, the iris, the anterior chamber and other interior parts of the eye
  • It refracts and focuses most of the light that enters the eye onto the retina, contributing to two-thrid of the refractive power of the eye.

It is a transparent avascular tissue layer, i.e. it doesn’t contain any blood vessels for nutrition. It receives all its nutrients from the tears, external air and the aqueous humour within the eye. Hence, it regenerates quickly from small abrasions as compared to other parts. 

Cornea, along with the tear layer and sclera, forms the outer coating of the eye. This coat prevents the internal parts from being exposed and be affected by surrounding elements while forming an anterior refractive surface. 

Cornea comprises of five distinct layers i.e., corneal epithelium, Bowman’s layer, corneal stroma, Descemet’s membrane and corneal endothelium which individually perform  their unique functions to keep the cornea intact and refract maximum amount of light falling on the eye. 

What Are The Most Common Corneal Disorders?

The corneal surface is vulnerable to a range of infections, diseases and disorders. Following are some of the commonly occurring conditions that damage the corneal surface:

When the corneal surface gets scared or degraded, its damaged surface fails to refract the incident light accurately onto the retina. This condition turns the otherwise clear cornea appear white and make your vision cloudy.

Corneal opacity is usually caused due to one or a combination of the following factors:

  • Vitamin A deficiency
  • Wearing contact lenses for an extended period
  • Injuries or contact with foreign bodies
  • Corneal scars caused by infectious agents such as bacteria or herpes simplex virus
  • Keratoconus, Stevens-Johnson syndrome, conjunctivitis, and other eye conditions
  • Congenital corneal abnormalities

If your eye starts clouding, it is a clear symptom of opacity. However, before the appearance of visible clouding, you may also experience other signs such as:

  • Loss or blurriness in the vision
  • Pain, irritation or itching sensation in the eye
  • Eye redness or excessive tearing, 
  • High sensitivity towards sunlight
  • Areas with milky patches in the eye

Corneal opacity is initially treated with eye drops and medications. In critical cases, Phototherapeutic keratectomy (PTK) laser surgery can prove more effective. Advanced cases can be helped by cornea transplantation

Keratoconus (KEHR-a-toh-kohn-nus) is a non-inflammatory eye condition in which the usually round, dome-shaped cornea thins and protrudes in a cone-like bulge, resulting in significant visual distortion. As the cornea is responsible for refracting most of the light coming into the eye, such abnormalities adversely affect the simple tasks, like driving, watching TV or reading a book.  The symptoms usually first appear in the late teens and early twenties. Keratoconus may progress for 10-20 years and then slow in its progression. As keratoconus progresses, the cornea bulges and thins, becoming more and more irregular, blurry and sensitive to light. Research suggests that an imbalance of enzymes within the corneal tissue causes it to weaken and lead to thinning & bulging of the cornea. Some commonly observed causes of keratoconus development include:
  • Genetic predisposition, causing oxidative damage
  • Overexposure to ultraviolet rays
  • Excessive eye rubbing 
  • Chronic eye irritation
  • Wearing poorly fitting contact lenses
Along with the blurred vision, keratoconus can also show signs such as:
  • Progressive nearsightedness and irregular astigmatism
  • Glare and light sensitivity
  • Frequent fluctuation in eyeglass and lens prescription
Keratoconus can be managed with a combination of cornea collagen crosslinking (CXL), contact lenses and eyeglasses. The need for cornea transplants is uncommon with modern management techniques. As it develops unpredictably, the lenses are customized based on the patients existing eye condition. The practitioner carefully evaluates the needs of the individual situation to find a lens that would offer the best combination of visual acuity, comfort and corneal health. You can learn more about contact lenses for keratoconus here…

The endothelium layer of the cornea is responsible for pumping back any fluid that flows through the eye. As these endothelial cells cannot regenerate, when they get damaged, fluids start to accumulate near the cornea causing it to swell. This swelling and clouding state of the cornea is known as Corneal Edema.

It is most commonly associated with other eye disorders such as Fuchs’ endothelial dystrophy, Endotheliitis, Glaucoma, Posterior polymorphous corneal dystrophy, and in rare cases, with Chandler’s syndrome.

Cataract surgery has also been found to damage the endothelial cells leading to corneal oedema.

Use of certain drugs such as chlorhexidine, amantadine and the ones that contain benzalkonium chloride can also increase the risk of developing corneal oedema.

People who develop this condition often show symptoms such as eye pain, seeing halos and glares around lights and feeling like something’s stuck in the eye.

What are the Treatments For Corneal Problems?

Corneal Collagen Cross-Linking with Riboflavin is specially developed for Keratoconus treatment. It is popularly known as C3R treatment. It is a minimally invasive procedure that stabilizes the keratoconus and prevents further deterioration of vision.

This treatment has undergone various trials and proven effective in arresting the progression of keratoconus and other corneal ectasias.

Corneal Collagen Cross-Linking Procedure:

The goal of this treatment is to increase the amount of collagen cross-linking, which are the natural “anchors” within the cornea that bond collagen fibres together.. These anchors are responsible for preventing the cornea from bulging out and becoming steep and irregular.

The cross-linking procedure is performed with two different methods:

Epithelium-off cross-linking:

  • In this technique, the epithelium layer of the cornea is removed and Riboflavin solution, a type of vitamin B, is introduced into the cornea.
  • This Riboflavin solution is then activated with controlled UV light.

Epithelium-on cross-linking:

  • Also known as transepithelial cross-linking, in this method, the corneal epithelium is left intact during the treatment. 
  • The Riboflavin solution is introduced over this layer, and controlled UV rays are used to activate it. 
  • The epithelium-on method requires more time for the riboflavin to penetrate into the cornea but also facilitates less risk of infection, less discomfort and faster visual recovery.

 Advantages of Corneal Collagen Cross-Linking:

  • A simple non-invasive treatment
  • This treatment strengthens the cornea. Only one-time treatment of C3R is required for keratoconus patients with less risk.
  • C3R treatment helps to reduce the cone shape of the cornea that is occurred due to keratoconus disease. An in-depth study of professional researchers stated that C3R helps to flatten the curvature entirely on a long time basis.
  • The main advantage of C3R treatment is: it can give some relief from progressive Ectasia.
Keratoplasty or cornea transplant surgery is warranted when the cornea becomes dangerously thin or when one can no longer use contact lenses due to the steepness of the cornea. If the rest of the eye (including the retina and optic nerve) is healthy, the cornea is replaceable through transplant surgeries. Corneal transplantation is one of the most successful organ transplant surgeries. The success of the procedure depends on the amount and type of damage the eye has sustained from disease or injury.  Cornea Transplant Procedure: Layered cornea transplantation: with new techniques separate layers of the cornea can be transplanted as needed e.g. epithelium, stroma or inner cell lining (endothelium).
  • In most cases, this cornea replacement surgery is done on an outpatient/daycare basis, and local anaesthesia is used during the procedure.
  • Your eyelids are carefully washed and covered with a sterile plastic drape.
  • The entire procedure is performed under a microscope. A circular cookie cutter-like instrument, called a ‘trephine’, is used to remove the centre of the diseased cornea. 
  • A button-shaped tissue layer of similar size is removed from the donor cornea. 
  • This donor tissue is then sewn in place of the patient’s cornea with extremely fine nylon sutures.
  •  A patch and shield are applied to protect the eye from foreign contact.
Corneal transplant for keratoconus can be performed in two ways: Penetrating keratoplasty (full-thickness corneal transplant) and Deep anterior lamellar keratoplasty (DALK) surgery. In Penetrating keratoplasty surgery, the entire central disc of the cornea is replaced with a similarly sized disc of a donor cornea. In DALK surgery, the healthy endothelial layer of the patient’s cornea is retained will the frontal two to three damaged layers are removed. The endothelial layer is the most vital layer of the cornea responsible for maintaining corneal clarity.  The other advantage of lamellar keratoplasty is that as the inner layer is retained, the immune cells of the body do not recognize the outer donor tissue as being foreign. Hence there is no risk of endothelial rejection with lamellar keratoplasty. You can find more in-depth information about keratoplasty on this page.

The goal of Intracorneal rings is to “defer” a corneal transplant and “stabilize” the cornea so that contact lenses or glasses can provide functional vision.

Intracorneal rings (ICRs), also known as ‘intrastromal corneal implants’, are two micro-thin, semicircular, bi compatible plastic rings of varying thicknesses.

These rings are used for keratoconus patients to reinforce the cornea and for reducing the elongated shape of the cone. 

Intracorneal Rings Implant Procedure:

  • The procedure is performed under topical anaesthesia. 
  • First, the geometric centre of the cornea is marked with a Sinsky hook as a reference point. 
  • With the help of a calibrated diamond knife, a 1 mm radial incision is created at 70-80% depth of the cornea.
  • Following which, corneal pockets are created on each side of the radial incision with pocketing hooks, and these pockets are further incised, and two semicircular tunnels are formed. These tunnels can be created using semicircular dissectors or a femtosecond laser.
  • Finally, the synthetic rings are inserted in these tunnels  

Intracorneal rings are designed using the latest surgical technologies and are perfectly tolerated by the eye. There is no risk of rejection. Although they are designed especially for treating low myopia (nearsightedness), they are mostly used for keratoconus patients of all ages.

Benefits of using intracorneal rings for keratoconus correction:

  • Surgery can be performed within the peripheral cornea without disturbing the central optical zone.
  • Quick and predictable results
  • Risk-free from visual adverse effects
  • Long term convenient refractive correction
  • Easily removable and exchangeable
  • Ideal for treating irregular astigmatism

Frequently Asked Questions:

Although some corneal conditions are congenital, it is also common in people who have jobs and hobbies that involve:

  • Sports that use a ball or puck, like baseball or hockey
  • Lawn Mowing or using a weedwhacker
  • Painting, welding and hammering
  • Machines like sanders or drills
  • Chemicals such as bleach or pesticides

Corneal conditions can be diagnosed in their early stages with periodic eye exams. The dilated eye exam is a painless and straightforward process used for such diagnosis.

Eye drops of fluorescein dye are used to check for corneal abrasions. These drops make small abrasions noticeable, helping the eye specialist during early-stage diagnosis.

Like any surgery, corneal transplant surgery has some risks. A major risk is if your body sees the new cornea as a foreign object, it tries to get rid of it. Other risks include infections, bleeding, retinal detachment or formation of Glaucoma.

Corneal transplant is performed as an outpatient surgery. Depending on the type of transplant, it can take up to a year to fully recover. It is recommended that you make a follow-up appointment the day after surgery to check how your eye is healing and talk with your doctor about when you can get back to your normal activities.

Today, it is relatively easy to get a cornea eye surgery and specialist surgeons are also widely available. However, before you start looking for cornea specialist doctors in Santacruz, Mumbai, you must know that cornea treatments require highly skilled doctors and advanced devices to minimize the risks and side-effects. Hence, look for an eye clinic which utilizes the latest technology and has experienced ophthalmologist to guide you. 

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