What is corneal degeneration?

Corneal degeneration is the gradual breakdown of the cornea, the clear dome at the front of the eye that covers the iris and pupil. The cornea is also responsible for refracting light, along with the lens of the eye, so corneal degeneration causes gradual loss of vision. While most forms of corneal degeneration are inherited, some are caused by injury or trauma, infection, vitamin A deficiency, or other environmental factors.

Two of the most common inherited disorders that cause corneal degeneration are keratoconus and Fuch's endothelial dystrophy. In keratoconus, the cornea becomes thin and conical, causing blurred or double vision, poor night vision, sensitivity to light, and sometimes itchiness. Keratoconus appears in childhood or adulthood and is more common in people with Down syndrome, but its genetic mechanism is not fully understood. It is treated with therapeutic contact lenses or surgery, depending on the severity of the condition.

Fuch's endothelial dystrophy manifests as swollen blisters or edema of the cornea, causing blurred vision, particularly in the morning, and pain. It is more common in women and the elderly, and can be triggered by surgical complications. Fuch's endothelial dystrophy is also treated with therapeutic contact lenses or surgery, most often corneal transplantation. Corneal edema can also be caused by environmental factors such as trauma, viral infection, glaucoma or damage to the optic nerve, and contact lenses that do not fit or wear for a long time. It is often treated with medication or a change in contact lens prescription, but advanced cases may require surgery.

Corneal ulcers are another possible cause of corneal degeneration. They can be caused by a bacterial, fungal, or viral infection, or by an injury to the cornea. Staph and strep bacteria, herpes simplex virus, and yeast infection are common causes of corneal ulcers. Corneal ulcers cause vision problems and severe pain. If left untreated, they can lead to scarring and eventually blindness.

Treatment for corneal ulcers often depends on the cause and may include antibiotics, antiviral medications, or steroids. In some cases, no medication is required and the ulcer heals on its own. Numbing eye drops may be used to control pain, and the eye may be bandaged to allow it to heal.

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