Cornea & Dry Eyes
Dry eyes and other corneal problems can cause significant discomfort and visual problems in today’s scenario. At Eye Life,™ our Cornea, dry eyes and ocular surface specialist Dr Sushmita Shah is an expert at diagnosing and treating dry eyes and other corneal problems like Keratoconus, Corneal infections or ulcers, Fuch’s endothelial dystrophy, macular dystrophy and other corneal dystrophies, post cataract surgery corneal edema, corneal scar, pterygium, limbal stem cell deficiency, chemical injuries, corneal tear etc. Having undergone fellowship training at prestigious institutions like Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, USA and at L V Prasad Eye Institute, Hyderabad, she is also an expert at performing myriad of corneal surgical procedures like advanced corneal transplantation (Keratoplasty) techniques like – DSAEK, DSEK, DALK, Boston Keratoprosthesis, Limbal Stem Cell Transplantation, Collagen cross linking(CXL), INTACS, Amniotic membrane transplantation etc.
Dry eyes can occur due to a myriad of causes which include Computer vision syndrome due to prolonged exposure to computers, post LASIK dry eyes, post cataract surgery dry eyes, Sjogren’s syndrome due to collagen vascular disease like Rheumatoid arthritis etc, Meibomian gland disease, chemical injuries, Steven’s Johnson Syndrome(SJS), Ocular cicatricial pemphigoid, post radiation exposure etc. At our Dry Eye Clinic, specialist check up tests are done and treatment provided for this very troublesome and common eye problem. Treatment for Dry Eye includes artificial tears and other drugs, punctal plugging, scleral and semiscleral contact lenses and various other surgical procedures.
Dry Eye Clinic - every Saturday 10am -12 noon, for Appointments –Contact - Eye Life Reception
KERATOCONUS stands for an abnormal corneal shape in which the cornea becomes conical in shape and continues to progress with increase in apical protrusion and thinning, resulting in visual loss. It can progress rapidly in young individuals if not diagnosed on time. Diagnosis can be done by a Cornea and eye specialist and can be confirmed on special test like Corneal Topography. Keratoconus can be very effectively treated in today’s era by Collagen cross linking(CXL), INTACS, Rose K contact lens, Kerasoft IC contact lens, and corneal transplantation (Deep Anterior Lamellar Keratoplasty, Penetrating Keratoplasty).
Corneal scars happen due to opacification of the cornea following corneal infections, corneal injury or trauma, corneal dystrophies etc resulting in loss of corneal transparency and loss of vision. Corneal scar can be adequately measured using optical coherence tomography and corneal topography and treatment can be planned. Treatment for corneal scars include non surgical treatment like specialised contact lens like Scleral contact lens, Kerasoft IC and Rose K contact lens, laser treatment like Phototherapeutic keratectomy and corneal transplantation.
Corneal infections or corneal ulcer can occur due to various causes like viral infections, trauma or injury, contact lens wear etc. It is common cause of “Red eye” along with decreased vision and can lead to blindness and loss of eye if not treated adequately. Eye check up with a cornea specialist is of utmost importance. Often microbiological evaluation is required to identify the causative organism or bug which has caused the infection. Treatment is with eye drops and oral medicines based on the microbiological diagnosis. In severe cases, not responding to eye drops, corneal transplantation may be required.
Corneal decompensation or loss of corneal clarity due to corneal edema or fluid entering into the corneal tissue. Common causes include - following complicated cataract surgery (Pseudophakic corneal edema), Fuch’s Endothelial Dystrophy, Viral infections, Descemet membrane detachment etc. Corneal decompensation can be effectively treated by transplanting the abnormal endothelial layer of the cornea – DSAEK (Descemet striping automated endothelial keratoplasty).
LIMBAL STEM CELL DEFICIENCY
Limbal stem cell deficiency(LSCD) or loss of stem cell on the ocular surface can cause permanent damage to the ocular surface resulting in severe visual loss and poor cosmetic appearance. Various causes of LSCD include Chemical injury-injury due to fall of acid or alkali into the eye (acid injury, alkali injury) Stevens Johnson Syndrome (drug reaction), Ocular cicatricial pemphigoid etc. However, various options are currently available which not only provide comfort but also improve vision in such patients. Treatment options in mild cases include Scleral contact lens, semiscleral contact lens, Boston Contact lens which provide ocular comfort and improve vision. For more severe cases, various ocular surface reconstruction techniques like amniotic membrane grafting, simple limbal stem cell transplant, conjunctival grafting, tenonplasty, Boston Keratoprosthesis are performed.
Corneal dystrophies are a group of genetically inherited disorders which affect both eyes. Corneal dystrophies can cause decreased vision, photophobia etc. Treatment for corneal dystrophy depends on which layer of the cornea is affected and the severity of the disease. For mild disease laser treatment like Phototherapeutic Keratectomy(PTK) works very well. For more severe disease advanced corneal transplantation techniqueslike Deep anterior lamellar keratoplasty(DALK), Descemet stripping automated endothelial keratoplasty(DSAEK).
Post cataract surgery corneal edema
Corneal edema following cataract surgery can lead to poor visual recovery. Various causes include injury to the cornea during cataract surgery, pre-existing corneal disease like Fuch’s endothelial dystrophy etc. Advanced corneal transplantation techniques like DSAEK – Descemet Stripping Automated Endothelial Keratoplasty.