Corneal Opacity Definition and Meaning
According to abbreviationfinder, corneal opacity is a disease of the cornea that occurs comparatively frequently. Nevertheless, it is relatively unknown, which is due to the numerous causes. Treatment is also difficult.
What is a corneal opacity?
A corneal opacity is a reduced transparency of the cornea. The clinical picture is usually caused by pathological or degenerative changes in the cornea and is often associated with a conspicuous discoloration of the outermost layer.
Corneal opacity can be triggered by a variety of things. It is most commonly caused by scarring or swelling on the cornea caused by ulcers or injuries. If the cornea swells, liquid penetrates it and slowly becomes cloudy. This reduces vision and permanently changes the color of the cornea. In addition, hereditary metabolic disorders such as corneal stromal dystrophy can trigger corneal opacity.
Injuries to the eye and especially to the cornea are generally a common cause of clouding. In particular, if there are thickenings that are not treated, the effect can remain permanently. Finally, a clouding of the cornea can also be caused by an infection with herpes viruses. These enter the eye through foreign objects such as contact lenses. Eye diseases such as keratoconus also cause corneal opacity.
Symptoms, Ailments & Signs
A clouding of the cornea first manifests itself as a reduction in vision. Those affected first perceive a visual impairment, which can manifest itself, among other things, in a clouded field of vision and excessive sensitivity to light. Those affected usually also notice a kind of foreign body sensation in the eye, which intensifies as the disease progresses and is perceived as very unpleasant.
Small blisters that hurt when touched can form in the area of the cornea. When the vesicles open, there is severe pain and there is a risk of acute eye inflammation. As the disease progresses, corneal ulcers may form. If the corneal opacity is not adequately treated, vision problems increase and eventually complete blindness occurs.
Previously, images were perceived as increasingly blurry and distorted, and the cloudiness often leads to falls or accidents in everyday life. Externally, corneal opacity is manifested by white discoloration, which forms a film on the cornea and makes the affected eye very cloudy. The discoloration intensifies as the disease progresses and eventually affects the entire eye. Sometimes there is also reddening of the edges of the eyes or visible keratinization in the area of the eyelids.
Diagnosis & History
The corneal opacity can usually be diagnosed by those affected themselves. This is done based on the various symptoms such as a reduction in vision and excessive sensitivity to light.
Small bubbles can also appear on the surface of the cornea. This is the case, for example, with untreated injuries. If one or more of the above symptoms are present, a visit to the ophthalmologist is advisable. He can narrow down the possible diseases in conversation with the person concerned and make the diagnosis on the basis of various examinations.
An eye test and a detailed examination of the cornea using a so-called slit lamp are important components of the examination. The exact diagnosis can be made if these examinations reveal white-grey discoloration in the area of the cornea. Thickening is also a clear sign.
The course of a corneal opacity is similar in most cases. At first, the affected person only perceives minor cloudiness and sees distorted and blurry images. If the opacity is not treated then, the affected person perceives less and less and eventually becomes completely blind. This process can drag on for years. It may also be that after a certain point the cloudiness stops progressing, but the limitations in daily life are still significant.
A corneal opacity that is not yet very advanced can often be treated conservatively. This treatment involves the fitting of a hard contact lens, which can be used to correct an existing refractive error. However, if the current situation does not stabilize with this lens, a corneal transplant may be necessary.
An inflammation of the cornea, which must be treated with antibiotics and anti-inflammatory drugs, can be concomitant or subsequently cannot be ruled out. There is a risk of damaging structures in or around the eye. Inflammation and healing disorders or scarring cannot be ruled out either. Bleeding and inflammation of the retina can occur, but fortunately are classified as very rare.
There is also a risk of renewed corneal clouding. This would result in another operation. In rare cases, retinal damage or allergic reactions occur. Ametropia that sometimes occurs or a change in the refractive power values can usually be compensated for with glasses or contact lenses, so that the complication usually does not lead to any serious limitations. In extremely rare cases, blindness or the loss of the operated eye occurs.
When should you go to the doctor?
One should always consult an ophthalmologist if symptoms such as severe sensitivity to light occur, possibly in combination with deterioration in vision and pain in the eye. If a corneal opacity is detected early enough, the chances of treatment are good. That is why it is important to go to the doctor as soon as the first symptoms appear. Risk groups include contact lens wearers, people who have had corneal injuries or ulcers in the past, and people with a history of herpes infection.
Those affected should have the symptoms examined at the first indication of corneal opacity. It makes sense to record them in a diary. These records are helpful to the doctor. If the corneal opacity is based on a hereditary predisposition, doctors try to carry out preventive treatment. A corneal opacity must be treated by a doctor, otherwise irreparable damage to the eye can occur, and in the worst case there can be a risk of blindness.
Treatment & Therapy
A corneal opacity cannot be remedied by conventional therapy methods. The only way to effectively treat opacity is to transplant a donor cornea. These are assigned via special corneal banks, for which there are long waiting lists. However, they can also be used immediately in an emergency situation such as an accident or a deterioration in the condition of the cornea.
Smaller scars or clouding can be remedied with the help of modern treatment methods, at least to the extent that those affected no longer have any difficulties in everyday life. A laser is usually used for this. In this form of treatment, known as phototherapeutic keratectomy (PTK), the hardened tissue that causes the opacity is carefully removed and the opacity is eliminated.
Since the procedure is risky, it is only an option if it is really necessary. If surgery is required, general or local anesthesia is used, depending on the situation. The surgeon uses a surgical microscope to remove the diseased cornea and then sews the donor cornea onto the eye. After the operation, the patient must also use antibiotics, ointments and other preparations to prevent inflammation. After a year, the sutures are finally removed and the patient regains full vision.
Outlook & Forecast
If the corneal clouding is caused by swelling in the eye after a fall or accident, the patient usually makes a full recovery once the swelling has healed. The prerequisite for this is that no permanent damage or irreparable damage has occurred.
In the case of a scar in the cornea or a patient with a metabolic disease, an individual analysis of the patient’s state of health must be carried out to determine which steps are possible to improve the patient’s health. Smaller scars can be treated with modern therapy methods. Significant alleviation of the symptoms or freedom from symptoms is often possible.
With larger scars or damage, the prognosis is unfavorable. Without surgery, there is no improvement in vision. A transplant is necessary so that there is a chance of alleviating the symptoms. For this purpose, the cornea of a donor is transplanted into the patient’s eye. If the operation is successful, a full recovery can take place. The transplanted cornea takes over all the functions of the removed tissue.
If complications occur or if the new cornea is rejected by the organism, the chances of a cure decrease drastically. Under certain circumstances, a new transplant can take place after some time. However, there are long waiting lists and a guarantee of success in the event of a renewed intervention cannot be given in advance.
Corneal clouding can be prevented in several ways. The risk is already minimized by not wearing contact lenses, as these can cause infections in the eye. In general, you should try to treat your eyes with care and avoid injuries and inflammation.
If foreign bodies get into the eye, a doctor should be consulted as soon as possible to avoid clouding of the cornea. An ophthalmologist should also be consulted if vision is impaired or other visual problems occur. The disease usually progresses insidiously, which is why those affected usually only recognize it when it is already too late.
Corneal opacity, which is hereditary, is difficult to prevent. However, the severity of the disease can be curbed with early treatment. The same applies if the clouding of the cornea is caused by an illness.
In the case of a corneal clouding, the aftercare measures prove to be relatively difficult in most cases, since complete healing cannot always occur. The earlier the disease is diagnosed and treated, the better the further course is, so that the patient should contact a doctor as soon as the first symptoms of this disease appear.
In most cases, the disease can only be completely cured if a donor cornea is available and this can also be transplanted. This procedure is usually performed under general anesthesia and is without complications. After the procedure, the affected person must take care of their eyes and not expose them to strong eyesight. The affected eye then becomes accustomed to normal sight over time.
It is also often necessary to take antibiotics to prevent inflammation. The person concerned should pay attention to the correct dosage and also to the regular intake of these medications. They should also not be taken with alcohol. Since the clouding of the cornea can also lead to psychological upsets or depression, intensive and loving conversations with your own family or friends are very useful.
You can do that yourself
Since corneal opacity manifests itself differently in each patient, the options for self-help in everyday life vary considerably.
In the case of a slight clouding of the cornea, in which there is still the possibility of regression, the patients take special precautions to protect the eye. So it is important to protect the diseased eye from overexertion. Such overloads come about, for example, through strenuous and long staring at various screens, for example when working on the computer or watching television. In addition, the eye must also be protected from stress caused by the weather, such as wind and direct sunlight. Applied to interiors, too bright light should also be avoided. Patients with corneal opacity initially do without contact lenses, as long as the doctor does not give his express consent. Meticulous eye hygiene protects the eye from infections that may further aggravate the clouding of the cornea.
In the case of severe corneal opacity with significant impairment of vision, it is important for those affected to come to terms with the situation and, if possible, to take adequate precautionary measures. This is particularly true at home, where changes to the furnishings or stronger color contrasts can improve orientation. Therapeutic offers support the patient to train his other senses more.