• Corneal Opacity

    (Corneal Opacification; Cloudy Cornea)

    Definition

    Corneal opacity is a disorder of the cornea, the transparent structure on the front of the eyeball, which can cause serious vision problems. Corneal opacity occurs when the cornea becomes scarred. This stops light from passing through the cornea to the retina and may cause the cornea to appear white or clouded over.
    There are many causes of corneal opacity. In some cases, your doctor can recommend a treatment that will reverse the opacity and lessen your chance of needing additional treatment, such as surgery.

    Causes

    Infection, injury, or inflammation of the eye are the most common causes of corneal opacity.

    Risk Factors

    The following factors increase your chance of developing corneal opacity. If you have any of these risk factors, tell your doctor:
    • Vitamin A deficiency
    • Measles (when measles result in scarring/infection of the eye)
    • Foreign bodies striking the eye
    • Eye injury, whether from a force, such as a poke in the eye, or from a chemical agent
    • Herpes simplex virus (which can be transmitted to the eyes)
    • Other infections, including conjunctivitis or "pink eye"
    • Additionally, wearing contact lenses for a long period of time, especially overnight, can increase the risk of eye infections and, as a result, increase the chance of developing corneal opacity.
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    Symptoms

    If you experience any of these symptoms, do not assume it is due to corneal opacity. These symptoms may be caused by other health conditions as well. If you experience any one of the following, see your eye doctor immediately:
    • Vision decrease or loss
    • Pain in the eye or feeling like there is “something in your eye”
    • Eye redness or light sensitivity
    • Area on the eye that appears cloudy, milky, or is not completely transparent

    Diagnosis

    Your doctor will ask about your symptoms and medical history, including illnesses and injuries, and perform a physical exam.
    To prepare for a comprehensive eye exam, your doctor may put drops in your eyes to numb them and to dilate the pupils. Your doctor will use a slit lamp (specialized microscope) to focus a high powered beam of light into your eye to examine the cornea and other structures in your eye.

    Treatment

    Talk with your doctor about the best treatment plan for you. Treatments vary depending on the most likely cause of the scarring and how severe the scarring is. Treatments may include:
    • Eye drops containing antibiotics, steroids, or both
    • Oral medications
    In some cases, scar tissue may be removed surgically. The surgery may be performed using a laser, called phototherapeutic keratectomy (PTK), if the scarring is close to the corneal surface. In more severe cases, a cornea transplant may be necessary.

    Prevention

    To help reduce your chance of developing corneal opacity, take the following steps:
    • Take care to avoid injuring the eye. Wear eye protection during any potentially dangerous activity. Make sure the safety goggles are worn tight against the face, otherwise a foreign body can fly up under the goggles and injure the eye.
    • Take proper care of contact lenses, and follow your doctor’s recommendations regarding wear and cleaning.
    • See your doctor immediately if you suspect you have an eye infection, including conjunctivitis (pink eye), if you injured your eye, or if you develop any pain or change in vision.

    RESOURCES

    American Academy of Ophthalmology http://www.aao.org

    National Eye Institute http://www.nei.nih.gov

    The Cornea Research Foundation of America http://www.cornea.org/

    CANADIAN RESOURCES

    Canadian Association of Optometrists http://www.opto.ca/

    Canadian Ophthalmological Society http://www.eyesite.ca

    References

    Abelson MD, Sleeper A. Insights on anti-inflammatories: A look at what we know about the efficacy and safety of steroids and NSAIDs. Review of Ophthalmology website. Available at: http://www.revophth.com/index.asp?page=1%5F743.htm . Accessed August 31, 2005.

    Ashaye AO, Oluleye TS. Pattern of corneal opacity in Ibadan, Nigeria. Ann of African Med. 2004;3:185-187. Available at: http://www.bioline.org.br/request?am04048 . Accessed August 31, 2005.

    Mabey DCW, Solomon AW, Foster A. Trachoma. Lancet. 2003;362(9379):223-229.

    Monino BJ. Inflammatory diseases of the peripheral cornea. Ophthalmol. 998;95(4): 463-472.

    Rangel TR. Sectoral keratitis and uveitis. Ocular Immunology and Uveitis Foundation website. Available at: http://www.uveitis.org/medical/articles/case/secker.html . Accessed August 14, 2005.

    Wong AL, Weissman BA, Mondino BJ. Bilateral corneal neovascularization and opacification associated with unmonitored contact lens wear. Am J Ophthalmol . 2003;136(5):957-958.

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