Corneal degeneration causes vision loss due to the gradual tearing of the cornea. Hereditary disorders like keratoconus and Fuch’s endothelial dystrophy are common causes, treated with contact lenses or surgery. Corneal ulcers caused by infections or injury can lead to blindness if left untreated and are treated with medication or bandaging.
Corneal degeneration is the gradual tearing of the cornea, the clear dome at the front of the eye that covers the iris and pupil. The cornea is also responsible for refracting light, along with the eye’s lens, so corneal degeneration causes gradual vision loss. While most forms of corneal degeneration are inherited, some are caused by injury or trauma, infection, vitamin A deficiency, or other environmental factors.
Two of the most common hereditary disorders that cause corneal degeneration are keratoconus and Fuch’s endothelial dystrophy. In keratoconus, the cornea thins and becomes conical in shape, causing blurry or double vision, poor night vision, sensitivity to light, and sometimes itching. Keratoconus appears in childhood or young adulthood and is more common in people with Down syndrome, but its genetic mechanism is not fully understood. It is treated with therapeutic contact lenses or surgery, depending on the severity of the condition.
Fuch’s endothelial dystrophy manifests as swollen blisters, or edema, in the cornea, causing blurred vision, particularly in the morning, and pain. It is more common in women and the elderly and can be triggered by surgical complications. Fuch’s endothelial dystrophy is also treated with therapeutic contact lenses or surgery, most often corneal transplant. Corneal edema can also be caused by environmental factors such as trauma, viral infections, glaucoma or optic nerve damage, and contact lenses that don’t fit or have been worn for too long. It is often treated with medication or a change in contact lens prescription, but advanced cases may require surgery.
Corneal ulcers are another possible cause of corneal degeneration. They can be caused by bacterial, fungal, or viral infections or by injury to the cornea. Staph and strep, herpes simplex virus, and yeast infection are all common causes of corneal ulcers. Corneal ulcers cause both impaired vision and severe pain. If left untreated, they can lead to scarring and eventually blindness.
Treatment for corneal ulcers often depends on the cause and can include antibiotics, antiviral drugs, or steroids. In some cases, medications aren’t needed and the ulcer heals on its own. Anesthetic eye drops may be used to manage the pain and the eye may be bandaged to allow it to heal.
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