Eye Problems

The Cornea

The cornea is the clear front window of the eye. It covers the iris (the colored portion of the eye) and the round pupil. The cornea is composed of five layers. The outermost layer is called the epithelium.

Injuries to the epithelium, such as scratches, cuts, or scrapes, are known as corneal abrasions. Usually, these injuries are caused by fingernail scratches, makeup brushes, paper cuts, or rubbing of the eyes. Sometimes conditions like dry eye can cause abrasions. Symptoms associated with corneal abrasions include tearing, redness, pain, soreness, and blurred vision.

Treatment options for corneal abrasions include patching the injured eye, dilating pupils to relieve pain, wearing special contact lenses that promote healing, taking antibiotics to prevent infection, and using lubricating eye drops.

Minor abrasions usually heal within a day or two, while larger abrasions take about a week.

Corneal Ulcers

Corneal ulcers, or keratitis, can form due to trauma to the cornea, eyelid disease, severe dry eye, fungus, herpes simplex viral infections, and other causes.

There are two very common types of corneal ulcers. Bacterial ulcers tend to be the most painful type of corneal ulcer, and in some cases, if left untreated, can cause severe damage or even corneal perforation. Sterile ulcers, on the other hand, usually cause little or no pain.

Improper care and handling of contact lenses, which can lead to infection, are often causes of corneal ulcers.

The symptoms of corneal ulcers may include:

pain;
redness;
blurred vision;
tearing;
discharge; and
sensitivity to light.

Treatment for corneal ulcers depends on the cause. It usually includes steroid eyedrops, anti-inflammatory drops, or antibiotics. In some cases, hospitalization may be necessary in order to administer eyedrops every hour around the clock, intravenous antibiotics, and other treatments. In rare cases when the cornea is severely damaged, a corneal transplant may be necessary to improve vision.

Glaucoma Evaluation

Because it has no noticeable symptoms, glaucoma is a difficult disease to detect without regular, complete eye exams.

During a glaucoma evaluation, your ophthalmologist will perform the following tests:

Tonometry. Your ophthalmologist measures the pressure in your eyes (intraocular pressure, or IOP) using a technique called tonometry. Tonometry measures your IOP by determining how your cornea responds when an instrument presses on the surface of your eye. Eyedrops are usually used to numb the surface of your eye for this test.
Elevated intraocular pressure (high pressure within the eye) is the number one risk factor for glaucoma.
Visual field test. The peripheral (side) vision of each eye is tested with visual field testing, or perimetry. For this test, you sit at a bowl-shaped instrument called a perimeter. While you stare at the center of the bowl, lights flash. Each time you see a flash, you press a button. A computer records your response to each flash. This test shows if you have any areas of vision loss. Loss of peripheral vision is often an early sign of glaucoma.
Photography. Sometimes photographs or other computerized images are taken of the optic nerve to inspect the nerve more closely for damage from elevated pressure in the eye.
Special imaging. Different scanners may be used to better determine the configuration of the optic nerve head or retinal nerve fiber layer.

Each of these evaluation tools is an important way to monitor your vision to help ensure that glaucoma does not rob you of your sight. Some tests may need to be repeated on a regular basis to monitor any changes in your vision caused by glaucoma.

Most cases of glaucoma can be well controlled with regular eye drops, some patients may require surgery in the future.

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