Common Corneal Diseases




Corneal ulcer



What is a Corneal ulcer?
  • A corneal ulcer is an infection of cornea which is a transparent glass like structure of the eye.
  • Corneal ulcer is caused by germs (micro organisms) which invade the inner layers of cornea and destroy it.
  • A person of any age can get a corneal ulcer and it is potentially a blinding condition


What are the risk factors of Corneal ulcer?
  • Usually injury to the eye is the most common cause which can lead to a corneal ulcer.
  • People who are contact lens users are also at a higher risk of getting a corneal ulcer
  • People with diabetes, dry eyes, repeated lid infections are at a high risk of developing and worsening of corneal ulcer


What are the symptoms of a Corneal ulcer?
  • Redness with sticky discharge may be the only symptom in the initial stages
  • People with corneal ulcer usually have pain and watering.
  • Decreased vision and difficulty in looking at light or bright objects
  • A white spot of infection may be visible on the black part of the eye along with other symptoms


How is Corneal ulcer treated ?
The treatment of Corneal ulcer is administered by a Cornea Specialist who is an eye surgeon specialising in the diseases of the Cornea. The mainstay of treating a corneal ulcer is prescribing the correct medicine for a particular infecting germs or microbes instead of starting a mixed bag of medicines.

Cornea specialists at Laxmi Eye Institute are trained in techniques of identifying these germs. The in house microbiology setup at Laxmi Eye Institute, backed by the expertise of our Cornea Specialists ensures that these germs can be promptly identified and optimum treatment can be initiated without having to wait for an external laboratory report.

Advanced and complicated Corneal ulcers may require complex surgical procedures for their treatment. Cornea specialists at Laxmi Eye Institute, are also trained and experienced in managing such difficult cases.

At Laxmi Eye Institute we are committed to our aim of continued medical care. To facilitate this we employ a state of the art photo documentation system which helps in monitoring progression or worsening of patients with Corneal ulcers.


Dry Eye



What is Dry Eye?
Dry Eyes is the catch all term which refers to the abnormalities in the tear layer which normally coats the surface of the eye. A healthy tear layer is needed for clear vision and also to protect the sensitive tissue of the surface of the eye.

What causes dry eye?
The human tear film consists of an aqueous (watery) layer with a thin lipid (oily) layer on top to retard evaporation and a thin mucous (sticky) layer underneath to help it adhere properly to the surface of the eye. Disturbance of any one or more of the three layers interferes with the process of routine lubrication of the surface. These disruptions, if prolonged, may cause one of the conditions that classify to be called dry eye.

What are the conditions which can lead to dry eyes? Who are at risk to develop Dry eyes?

There are many different causes of the conditions collectively referred to as dry eye syndrome, which include; aging, menopause, prolonged computer use, environmental (dry climates, air conditioning, pollution, wind), auto-immune diseases (e.g. Sjögrens Syndrome, RHEUMATOID ARTHRITIS, LUPUS), surgeries on the eyes or eyelids (e.g. BLEPHAROPLASTY, LASIK, LASEK, PRK, corneal transplants, etc.) and medication side effects.

What are the symptoms of Dry eyes?
Symptoms of dry eyes vary greatly. Some of the most common symptoms are:
  • Feeling like there is something in your eye (foreign body sensation)
  • Scratchy, gritty eyes, smarting or burning eyes
  • Watery eyes
  • Sensitivity to light
  • Eyes tire easily, particularly noticeable from reading, watching TV or using a computer
  • Contact lens discomfort or intolerance
  • Excessive mucus discharge
  • Eyes easily irritated by smoke, allergens, fragrances, etc.
  • Fluctuating vision
  • Blurred vision, particularly first thing in the morning, and/or late in the day
  • Eyelids "stick shut" at night
  • Eyelids feel "heavy"
How is Dry eyes diagnosed? Does it require many complicated tests?
Diagnosis of dry eyes is a simple clinic based procedure. Doctors at Laxmi Eye Institute can easily perform minor tests in their clinics which take less than 10 minutes to do. Sometimes, the Cornea specialists may advise certain blood tests to determine the cause of dry eyes.

Is there a cure for Dry eyes?
Though there is no permanent cure for Dry eyes, it can be treated by one or more of the following ways:
  • By supplementing the deficient tears in the eyes with artificial tear drops prescribed by the doctors.
  • By preserving the natural tears produced by your eyes from draining into the nose and keeping them in contact with the eye for a longer time by using silicone plugs which block the draining ducts or using heat to permanently block these ducts.
  • By preventing excessive evaporation of the tears. This can be done by lifestyle modification and also by modifying the environment. Using wrapa round glasses to prevent wind drying the eyes, using humidifiers at home in dry conditions, reducing use of air conditioning can all help relieve dry eye symptoms.
  • Other treatments of dry eyes include supplementing the diet with omega 3 fatty acids which are found naturally in Oily fish and Flax seeds. Alternatively, prescription drops like Cyclosporine, or steroids are used to treat dry eye symptoms. However, these medicines should be used according to doctor’s instructions only.
  • Treatment of the general body disease also helps in controlling the dry eye symptoms.



Eye Allergies



What is Eye allergy (allergic conjunctivitis)?
Eye allergy (allergic conjunctivitis) is an abnormal response of the conjunctiva (translucent membrane covering the white of the eye) to environmental irritants (known as Allergens) which lead to itching, redness, watering and sticky rope like discharge.

What are the Allergens?
The allergen could be any substance which you come in contact with. The most common ones are dust, pollen, mites, moulds and other particulate matter in the air which come in contact with your eyes. However, a person can be allergic to any other substance apart from those mentioned here. Though there are tests to determine a person’s particular allergen it can never be exhaustive enough.

Who can get Eye Allergy?
Eye allergies can affect adults and children alike. The tendency to get eye allergies runs in families. People with Asthma, Allergic dermatitis or Contact dermatitis, recurrent cold and sinusitis are at a higher risk of getting allergic eye disease.

How can Eye Allergy be prevented?
The ideal thing to do would be to completely avoid exposure to the allergen. However, this is not possible most of the times. Hence, lifestyle modification by wearing large frame glasses, avoiding dry dusty and windy situations and keeping other allergic diseases under check will help to suppress manifestations in the eye.

What is the treatment of allergic eye disease?
Allergic eye disease can be controlled by a combination of lifestyle modifications and medicines.
  1. Cold compresses with soaked cloth or ice packs helps to suppress the urge to itch.
  2. Avoiding vigorous eye rubbing is of paramount importance, especially in children, to avoid changes in corneal shape and blurring of vision.
  3. Eye drops are the mainstay of treatment of eye allergies. Sometimes, eye drops have to be used all year long.
  4. Rarely the doctors may prescribe tablets in severe cases.
  5. In children allergic conjunctivitis may gradually subside in the late teen ages and they can be taken off medication.


Doctors at Laxmi Eye Institute have ample experience in treating allergic eye diseases in both adults and children.


Keratoconus



What is Keratoconus?
Keratoconus is an abnormality of the shape of the cornea in which the cornea progressively bulges forward and starts to thin out. This leads to change in the optical properties of the cornea and leads to blurring of vision

Who can get Keratoconus?
Keratoconus has some genetic basis which means it can run in families and affect cousins too. Usually these families have an inherent weakness in the corneal structure which can lead to the abnormal bulging and thinning. However, people with absolutely no family history of Keratoconus can get affected too.

It is also associated with other conditions like
  1. Allergic diseases of the eyes
  2. Hard Contact Lens wear
  3. Retinitis Pigmentosa
  4. Lebers Congenital Amaurosis
  5. Downs Syndrome
  6. Mitral Valve prolapse
  7. Osteogenesis Imperfecta
What are the symptoms of Keratoconus?
Blurring of vision is the most common complaint of patients with Keratoconus. It may also be associated with frequent change of your glass power. Apart from this Keratoconus may also lead to:
  1. Distortion of images
  2. Glare and haloes or rings around light source
  3. Loss of contrast specially in dim light


Rarely, patients with Keratoconus may have sudden onset pain and severe blurring of vision with whitish appearance of Cornea.

Can Keratoconus be prevented?
No. However, the progression of Keratoconus can be delayed by avoiding eye rubbing. Newer treatment modalities can also halt the progression of Keratoconus and arrest it at an initial stage.

How will the doctors know whether my disease is progressing?
Newer technology allows the Cornea specialist to get a perfect picture of the changes in the shape of the diseased cornea. This technology known as Corneal topography, which involves a quick scan of the cornea on specialised machines, allows the Cornea specialist to determine whether your disease is progressing. At Laxmi Eye Institute we boast of having the most modern machine known as the Oculyser which can quickly get an accurate scan of your eye.

How can Keratoconus be treated?
The goal of Keratoconus treatment is to prevent progression and to take care of the blurring of vision. At Laxmi Eye Institute a wide variety of treatment options can be availed.

Corneal Collagen Cross Linking: This is a decade old procedure which can increase the strength of the corneal tissue and halt the progression of the disease. At Laxmi Eye Institute, the Cornea specialists perform this simple procedure to halt the progression of the disease. It involves soaking the cornea in a special medicine followed by exposing it to a safe Ultraviolet light. At Laxmi Eye Institute the patients can avail this treatment with one of the state-of-the-art machines available.

Spectacles: In the initial stages of the disease spectacles alone may suffice to correct blurring of vision.

Contact Lenses: Contact lenses are an indispensable mode of treatment of Keratoconus. By sitting on the cornea and effectively nullifying the abnormalities of the corneal shape, Contact lenses provide a sharp image formation which is otherwise not possible with spectacles. At Laxmi Eye Institute we have a dedicated Contact Lens department with technicians and optometrists specially trained in the art and science of fitting advanced contact lenses. This allows us to offer our patients a wide basket of Contact Lens options for Keratoconus which can suit their stage of disease and budget.

Corneal transplants: Very advanced stages of Keratoconus may require replacing the diseased cornea with a new one from a cornea donor in a procedure called Corneal Transplantation. Cornea specialists at Laxmi Eye Institute are well versed with all the modern techniques of Corneal transplantation. Having a fully functioning Eye Bank ensures that a patient does not have to wait too long to receive a donor cornea.

At Laxmi Eye Institute , we believe in tailoring the treatment to our patients’ needs. We strive to offer the most effective, ethical and economical treatment to our patients.


Diseases of the Ocular surface



What is the Ocular Surface?
The Ocular Surface is that portion of the eye which is in direct contact with the external environment. This mainly involves the tear film, the Cornea and the Conjuctiva (thin, translucent membrane covering the white part of the eye). However, the Eyelids and Tear glands can also be included in the ocular surface as there is constant interaction between all these structures. Maintaining a healthy ocular surface is supremely important to maintain the flawless transparency of the Cornea, and by extension for clear vision.

Which diseases can affect the Ocular surface?
Many diseases can affect the Ocular surface. They can be as innocuous as mild Dry eye or as complex as severe Chemical Burns of the eye or scarring due to Stevens Johnson syndrome or Ocular Cictatricial Pemphigoid. Cornea specialists at Laxmi Eye Institute are trained under world reknowned scientists and clinicians in the art and science of treating both acute and long term effects of these diseases.

What are the symptoms of Ocular Surface diseases?
Ocular Surface diseases can present with many different symptoms. In the initial stages they can be
  1. Dryness of the eye with a constant redness and irritation
  2. Persistant pain.
  3. Blurring of vision or fluctuating vision
  4. Increased sensitivity to bright and later ambient light
  5. Progressive whitish appearance of the cornea.
In advanced stages patient can suffer from
  1. Inability to open eye
  2. Thick fleshy mass growing from lid to cornea leading to poor eyesite
  3. Cornea or the eye getting hidden completely


At Laxmi Eye Institute, a detailed examination of all such conditions is carried out in the Cornea deparment and a detailed treatment plan is formulated.

What are the treatment options available for Ocular Surface diseases?
Depending upon the stage and severity of the disease, Ocular surface conditions may be treated
  1. Medically with eye drops and oral medications
  2. Advanced Contact Lenses
  3. Human Amniotic Membrane transplantation
  4. Conjunctival autograft
  5. Ocular surface reconstruction
  6. Stem Cell Transplantation from the patients other healthy eye or living relative or a non related donor
  7. Lid margin and Ocular surface Mucous Membrane Grafts.
  8. Keratoprosthesis (Artificial Cornea Transplantation)
At Laxmi Eye Institute, these advanced treatments may be availed under the same roof.