The cornea is typically clear and transparent, allowing light to pass into the eye. The cornea bends light to help focus images on the retina in the back of the eye. A corneal scar is either opacity or irregularity in the cornea that can limit the cornea’s ability to accurately focus light. Not all scars affect vision. If a scar is on the outer edges of the cornea, it may not alter the vision at all. However, if a scar is in the central cornea, over the pupil, it may cause a significant loss of vision.
Corneal scars have many causes, the most common are:
Injury or trauma
Diseases of the cornea or eye surfaces such as Keratoconus or Severe Dry Eye
How Is a Corneal Scar Diagnosed?
Most corneal scars are easy to diagnose during a routine eye exam. They look like a white opacity in the normally clear cornea. Sometimes, corneal scars are visible to the naked eye. Some types of scars are more difficult to detect. Scars that change the shape of the cornea, making the surface more irregular, may not be apparent to your doctor with a routine exam. In these cases a corneal topography may aid in the diagnosis. Corneal topography is like a topographical map of the cornea that shows if the surface is misshapen or irregular.
A corneal scar may not change over time, particularly if was caused by an injury or infection. However, some scars can worsen over months and years if they are associated with underlying eye diseases. It is important to determine the cause of scarring in order to prevent scarring from worsening over time.
How Is a Corneal Scar Treated?
The cornea-trained specialists at Northeast Ohio Eye Surgeons can diagnose a corneal scar and have many treatments available to help improve and restore vision. For milder scars, glasses alone may improve the vision. If a scar is more severe glasses may not help and special contact lenses may be very useful in improving vision. RGP (Rigid Gas Permeable) and scleral lenses are contact lenses that are stiffer than ordinary lenses and they create a new, smoother surface to the cornea that can dramatically improve the vision. The doctors at Northeast Ohio Eye Surgeons have extensive experience with these lenses and lecture nationally regarding their use in improving vision.
In severe cases of scarring, the vision may not improve with the use of contact lenses. In these situations, a corneal transplant can be considered. With a transplant, your ophthalmologist replaces all or part of your diseased cornea with healthy donor cornea tissue. The surgeons at Northeast Ohio Eye Surgeons use the most advanced techniques for corneal transplantation for corneal scars, such as DALK and PK. DALK (Deep Anterior Lamellar Keratoplasty) preserves the innermost layer of the cornea, provides a speedier recovery, and prevents transplant rejection.