Corneal opacity

CORNEAL OPACITY
By- Abhishek Yadav
Optometrist
Community Ophthalmology
Dr. R. P. Centre for Ophthalmic Sciences

WHAT IS CORNEAL OPACITY?
 Corneal opacity is a disorder of the
cornea. The cornea is the transparent
structure on the front of the eyeball.
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.
 Common causes include Infection,
injury, corneal abrasion or scratch or
swelling of the eye

RISK FACTORS
 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
 Wearing contact lenses for a long period of time, especially
overnight, can increase the risk of eye infections and also the chance
of developing corneal opacity.
 Keratoconus
 Stevens-Johnson syndrome
 Congenital corneal abnormalities

DO YOU HAVE CORNEAL OPACITY?
 Vision decrease or loss
 Pain or a feeling like there is something in your
eye
 Eye redness, excessive tearing, or light
sensitivity
 Area on the eye that appears cloudy, milky or is
not completely transparent

NEBULA
 Faint opacity
 Superficial scars (bowmans and stroma)
 Covers the pupillary area
 Blurring vision and irregular astigmatism

MACULA
 Scarring of about half of the corneal stroma
 Semi-dense opacity

LEUCOMA
 Dense white opacity
 Scarring of more than half of the corneal stroma
ADHERENT LEUCOMA
 Seen when healing occurs after perforation of cornea with
incarceration of iris

ANTERIOR STAPHYLOMA
 An ectasia of psuedocornea(the scar formed from organised
exudates and fibrous tissue covered with epithelium) which results
after total sloughing of cornea, with iris plastered behind it is called
anterior staphyloma

CORNEAL FACET
 Sometimes the corneal surface is depressed at the site of healing
(due to less fibrous tissue); such a scar is called facet.
KERACTASIA
 In this condition corneal curvature is increased at the site of opacity
(bulge due to weak scar).
SECONDARY CHANGES IN CORNEAL OPACITY
 which may be seen in long-standing cases include: hyaline
degeneration, calcareous degeneration, pigmentation and
atheromatous ulceration.

Diagramatic depiction of corneal opacity: A, nebular;
B, macular;
C, leucomatous;
D, adherent leucoma

TREATING CORNEAL OPACITY
 Eye drops containing antibiotics, steroids or both
 Oral medications
 Phototherapeutic keratectomy (PTK), laser surgery
 Cornea transplant

PREVENTION
 Take care to avoid injuring the eye. Wear eye protection during any
potentially dangerous activity. Make sure 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. Follow your doctor’s
recommendations regarding wear and cleaning them.
 See your doctor right away if you think you have an eye infection, if
you injured your eye, or if you develop any pain or change in vision

BURDEN
In India, it is estimated that there are approximately 6.8 million people who
have vision less than 6/60 in at least one eye due to corneal diseases; of
these, about a million have bilateral involvement. It is expected that the
number of individuals with unilateral corneal blindness in India will
increase to 10.6 million by 2020.
According to the National Programme for Control of Blindness (NPCB)
estimates, there are currently 120,000 corneal blind persons in the
country. According to this estimate there is addition of 25,000-30,000
corneal blindness cases every year in the country. The burden of corneal
disease in our country is reflected by the fact that 90% of the global cases
of ocular trauma and corneal ulceration leading to corneal blindness
occur in developing countries.

 The causes of corneal scarring were Vitamin A deficiency (19%),
measles in 3%, ophthalmia neonatorum in 1%, harmful traditional
eye medicines in 1% and trauma and keratitis in the remaining 3%.
 3.7% is the prevalence of corneal opacity in total population of India.
NEED FOR DONATION TO RESTORE LIGHT
•Annually around 55,000-60,000 corneas collected out of which approx 40-
50 cornea can be utilized

Corneal opacity

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