What are Corneal Diseases and Conditions That Affect the Cornea?

In this article, we will discuss corneal diseases and conditions that affect the cornea. The conditions we will discuss can be treated in today’s world.

1. Allergic Reactions

Allergic reactions are among the factors that have a negative impact on the cornea. Especially, discomfort such as redness, itching, and burning is often observed due to pollen allergies. It is also known that some eye medications and contact lenses can create allergenic agents on the cornea.

2. Conjunctivitis

The conjunctiva is a highly important tissue that protects the sclera and eyelids of the eye. Infections that affect the conjunctiva can have negative effects on the eye, causing problems such as swelling, itching, and burning. This condition is contagious and can easily spread from person to person. If conjunctivitis is not treated, it can even lead to permanent vision loss.

3. Corneal Infections

There are various bacteria, viruses, and fungi that can negatively affect the cornea. These external factors can lead to various conditions, much like allergic reactions. An infection called keratitis can be extremely troublesome. Symptoms of keratitis include eye pain, a burning sensation, white spots, blurred vision, and redness. Bacteria, viruses, and fungi can all cause this condition. Additionally, rheumatic diseases can also lead to a form of keratitis.

4. Corneal Dystrophies

Corneal dystrophies refer to the loss of transparency in the cornea, causing it to become cloudy, often due to genetic diseases. As a result of this condition, a person cannot see clearly. Corneal dystrophies can also occur due to hereditary factors.

5. Corneal Ulcer

Corneal ulcer is known as a condition that is often complained of by people who sleep with their eyes not completely closed. Corneal ulcer is a condition that occurs due to dryness in the eyes. If this condition is not treated, it can lead to vision loss.

6. Pterygium

Pterygium is the term used for the growth of tissue on the edge of the eye, advancing onto the cornea. This condition is often observed in individuals who work outdoors for extended periods in the sun. Unless there is a vision-related problem, surgical intervention is not necessary.

7. Dry Eye Syndrome

Dry eye syndrome is one of the commonly seen eye conditions. Tear production, which is essential for preventing eye infections, itching, and protecting the eyes from infections, is significantly reduced in individuals with dry eyes. This condition can lead to symptoms such as burning, stinging, and itching in the person’s eyes.

8. Keratoconus

Keratoconus is a condition that leads to the distortion and forward tilting of the cornea. This condition is the cause of astigmatic visual impairment. It is explained by the forward curvature of the cornea and is also referred to as corneal bulging. This condition typically begins around the ages of 15 to 17 and progresses until the age of 35 to 40. The course of this disease can vary from person to person. In the early stages of the condition, the most common complaint is the frequent change in eyeglass prescription. As the disease progresses, clear vision cannot be achieved.

9. Corneal Abrasion

Keratoconus is a condition that leads to the distortion and forward tilting of the cornea. This condition is the cause of astigmatic visual impairment. It is explained by the forward curvature of the cornea and is also referred to as corneal bulging. This condition typically begins around the ages of 15 to 17 and progresses until the age of 35 to 40. The course of this disease can vary from person to person. In the early stages of the condition, the most common complaint is the frequent change in eyeglass prescription. As the disease progresses, clear vision cannot be achieved.

Eye Diseases Specialist

Prof. Dr. Tayfun Bavbek

Focused on providing better eye health services through coordinated clinical care.

Bavbek provided information on common eye diseases in children on the occasion of April 23rd National Sovereignty and Children’s Day.

Bavbek emphasized the importance of bringing every baby for a follow-up eye examination around the age of 1 year after the initial eye examination conducted in the first month after birth. He noted that parents should be more aware of congenital eye diseases.

Bavbek summarized the most common eye disorders encountered in newborns as congenital cataracts, eye pressure, retinoblastoma, tear duct blockage, and premature retinopathy.

Parents can analyze the symptoms of congenital cataracts.

Bavbek stated that one of the possible eye problems that infants can encounter within the first few months after birth is “congenital” (congenital cataract). He mentioned that if not diagnosed early, this condition can lead to serious amblyopia (lazy eye), and the only treatment in later stages is surgery.

Bavbek provided an important clue to parents for discovering the symptoms of congenital cataracts, stating, “There is an easy way to test for congenital cataracts. You can take a photo of your child and check their eye pupils. If there is no red reflection in one eye or both eyes, this could be a sign of congenital cataracts, congenital eye tumors, or retinoblastoma. At this point, it is crucial for parents to be vigilant and have their children’s eye health checked regularly for early diagnosis.”

Prof. Dr. Tayfun Bavbek also mentioned another congenital disease, glaucoma, and at this point, he warned, “If your child is excessively sensitive to light, experiences excessive tearing in the eyes, or has enlargement of the eyeball, it is advisable to be cautious and consult an eye doctor.”

Tear duct blockage can be opened with massage and eye drops

Bavbek stated that the blockage of the tear duct is among congenital eye disorders, and in some babies, excessive crusting and tearing can occur due to blockage in the tear duct.

Bavbek, stating that this condition can be treated up to 90% with massage and drops until the baby is 9 or 10 months old, mentioned that if the tear duct is still not open at 10 or 11 months, doctors prefer to open it with a probe.

Bavbek stressed the necessity of examining premature babies born weighing less than 500 grams for a condition known as premature retinopathy during the fourth week after birth. He continued, “Due to the underdevelopment of blood vessels in the retina in premature babies, exposure to external oxygen upon leaving the mother’s womb can lead to various pathological issues. Failure to diagnose this condition early can result in dangerous consequences, including vision loss in the future.”

The age limit for the treatment of lazy eye is 7

Prof. Dr. Tayfun Bavbek stated that through regular eye check-ups, conditions such as strabismus (crossed eyes) and differences in prescription between the two eyes can be detected in infants before the age of 1. He emphasized the prompt initiation of treatment, saying, “Strabismus and differences in prescription between the two eyes are the two most common reasons for lazy eye, a condition frequently encountered in our society. Strabismus, if not treatable with proper glasses, may require surgery as a secondary option. If your child has an eye misalignment, the nerves in the visual center cannot develop properly due to the inability to focus accurately, paving the way for lazy eye. Similarly, if there is a difference in prescription between the two eyes, the use of glasses is recommended for treatment. It is also important to monitor whether the prescription is progressing.”

Bavbek warned that if this process is neglected, lazy eye can reach a serious level. He continued, “In the case of lazy eye, treatment is possible until the age of 7 at most. If timely treatment is not provided, this condition becomes permanent for a lifetime. The most important responsibility for parents to prevent lazy eye from becoming permanent is to take their children for an eye check-up once a year until they reach the age of 7.”

The greatest danger in household accidents is sharp objects

Bavbek noted that particularly in preschool children, household accidents often involve issues such as sharp objects like knives, needles, pens, and scissors coming into contact with the eyes.

Bavbek, pointing out that children’s interest in laser pointers can lead to permanent eye problems, commented, “We had a young patient who, out of curiosity, pointed a laser pointer into his eye for just one minute, resulting in a burn in the visual center. Parents must take precautions against potential accidents that can occur at home.”

Eye allergy season has arrived. Especially if you have allergies to pollen and dusty environments, you need to pay more attention to your eye health than usual during the spring and summer months when your allergy is constantly triggered. So, what triggers eye allergies? Eye allergies can be caused by pet dander, dust, pollen, smoke, perfume, and even occasionally by certain foods. 

Since eye allergy is a chronic condition, it has a recurring cycle during certain periods.

Prof. Dr. Tayfun Bavbek, highlighting that allergic reactions can intensify when the cause of eye allergy is not identified, said, ‘Eye allergy is a chronic condition. It has a recurring cycle during certain periods. Individuals with eye allergies may also experience nasal allergies. Although symptoms such as itching, congestion, and sneezing of the nose may occur, this is generally a temporary process related to seasonal allergies. The most common symptoms of eye allergy are redness, swelling, itching, burning, watering, and sensitivity to light in the eyes.

Bavbek, stating that eye drops are the most successful method used in the treatment of this process, said, ‘Individuals with eye allergies should use drops about 4 times a day as soon as their discomfort begins to increase. In very severe cases, our clients may need to use cortisone. However, due to its many side effects, individuals should not use this medication on their own. It needs to be used under the close supervision and control of an eye doctor. The important point here is that these types of medications only eliminate the symptoms… Since eye allergy is a chronic condition, it can recur and intensify during certain periods.

What should be considered in eye allergies?

• If you are allergic to pollen, try to avoid going outdoors during times when the amount of pollen in the air is at its highest.
• Especially during the summer months, do not go outside without your glasses and hat.
• Keep the windows in your home and car closed and use air conditioning. This way, you can lower your level of exposure to pollen and other irritants indoors.
• It is very important for people with allergic constitutions to have the air conditioners they use in their homes checked and cleaned at regular intervals.
• Moldy environments are another factor that triggers eye allergies. Therefore, clean areas with high humidity like basements, bathrooms, and kitchens frequently. You can make the environment more suitable for your eye health with dehumidifying devices.
• Definitely use hypoallergenic bedding sets in your bedroom.
• If your eye allergy is triggered by cat or dog fur, try to keep your pets outside the house as much as possible.
• When your eye allergy starts, never rub your eyes. Otherwise, you will increase the irritation. At this point, the only thing you need to do is to use the eye drops prescribed by your eye doctor.

Surgical intervention around the eyes can be considered for two reasons. Firstly, for aesthetic reasons such as eyelid edge wrinkles that create a tired, sleepless appearance, bagging in the eyelids, or wrinkles and sagging in the eyelids; secondly, for functional reasons in cases where ptosis, i.e., drooping of the upper eyelid, or sagging of the eyelids impairs vision, or when the eyelid anatomy is disrupted due to burns, accidents, or cuts, affecting eyelid functions.

Crow’s feet, also known as light eyelid edge wrinkles, can be treated with non-surgical methods. Injection of botulinum toxin into the skin temporarily paralyzes the nerve that moves that area, preventing the expressions that cause wrinkles, and very successful results are obtained temporarily with a simple injection without the need for surgery. Sometimes it may be necessary to repeat the botulinum toxin injection.

The eyelids are curtains made of skin, muscle, and fibro-elastic layers, located in front of the eyeball and covering the base of the orbit, serving to protect the eye from excessive light and external influences.

When the free edges of the upper and lower eyelids touch each other or move apart, the front part of the eyeball is covered or revealed. These movements are referred to as the opening and closing of the eye.

The upper eyelid is larger than the lower eyelid, and it is only this lid that moves up and down during the opening and closing of the eye. When the eye is open, the lower eyelid is located 1-2 mm below the lower edge of the cornea, while the upper eyelid extends slightly over the top of the cornea, about 1 mm. When the eye closes, the lower eyelid rises to the lower edge of the cornea; the upper eyelid moves downward from above, covering the entire cornea.

Blepharoptosis, characterized by drooping of the upper eyelid and the inability to sufficiently lift the affected eyelid, is a fairly common pathology that concerns both plastic and reconstructive surgery, as well as ophthalmology.

In blepharoptosis, the normal eyelid gap of 8-10 mm is narrowed. The ptotic upper eyelid not only disrupts the appearance of the person’s face, which is important from an aesthetic standpoint, but in severe cases, it also covers the visual axis, creating significant problems for vision. Particularly in children, a ptotic upper eyelid that covers the visual axis can lead to deprivation amblyopia.

Surgical treatment plays an important role in cases of blepharoptosis to maintain normal eye function and achieve a symmetrical appearance. However, in this condition, where many surgical techniques have been tried, and new techniques are still being published, an optimal method has not yet been determined.

The eyes, being the most advanced organ in the body in terms of aesthetics and function, hold a significant place in surgical treatment for maintaining normal eye function and achieving symmetrical appearances in cases of blepharoptosis. The goal of ptosis surgery is to lift the drooping eyelid and create a well-defined eyelid crease to achieve the closest possible cosmetic result to perfection. Despite advancements in surgical techniques, predicting the postoperative outcome in some ptosis cases can be challenging. Sometimes, postoperative revision may be necessary. There is no single method that can correct ptosis in all cases. While the primary aim is to correct ptosis, it’s essential to consider the eye’s protective mechanisms and etiological factors when deciding on surgery.

Complications in ptosis surgery can arise due to incorrect surgical choices and technical errors. Therefore, the most appropriate surgical technique should be selected based on the type of ptosis, the degree of ptosis, levator function, and other characteristics of the cases. From a surgical perspective, it’s advisable to choose techniques that the surgeon is most experienced with, and if necessary, methods that allow for a second operation. Easy and effective methods should be preferred.

In cases of bilateral severe ptosis, the head is tilted backward to open the visual axis, and the frontalis muscle is used to lift the eyelid, causing the eyebrows to be raised. As a result, horizontal wrinkles may develop on the forehead and vertical wrinkles may appear at the root of the nose.

In light of all this, when it comes to eyelid procedures, whether they should be performed by a plastic surgeon or an eye doctor, the answer should be an oculoplastic surgeon. Whether they are a specialist in aesthetic and plastic surgery or an ophthalmologist, they should be a surgeon who has specifically studied eyelid and periocular diseases and anatomy and has experience in this field.

Keratoconus typically emerges at a young age. This condition, which starts during adolescence or in the early twenties, can be treated depending on its progression. Wearing glasses or lenses in the early stages can help resolve this issue. If no solution is found in the early stages, a corneal transplant may even be necessary.

Keratoconus is generally a condition that can be treated without surgical intervention. However, not using glasses and lenses can trigger the progression of the disease, so it is extremely important to be vigilant in this regard. Therefore, undergoing routine eye examinations at regular intervals is of great importance.

What causes keratoconus?

In recent years, significant research has been conducted on keratoconus. These studies have led to some theories about the causes of keratoconus. Accordingly, keratoconus results from the weakening of the corneal tissue and an imbalance of collagen within the cornea. An imbalance of enzymes in the cornea causes free radicals to make the cornea more susceptible to oxidative damage.

Among the causes of corneal damage, weakening, and enzyme imbalance, genetic factors also play a role. In some individuals, there is a predisposition to this condition.

Keratoconus is sometimes a condition that can be observed due to external factors. Harmful ultraviolet rays from the sun can also cause deterioration in the structure of the cornea. Additionally, excessive eye rubbing, wearing contact lenses, and irritation that can occur in the eyes are also among the triggers of keratoconus.

Symptoms of Keratoconus

Treatment Methods for Keratoconus

1. Corneal Cross Linking

With CCL (Corneal Cross-Linking) treatment, the bonds between collagen fibers in the cornea are strengthened. The use of Ultraviolet A and B2 vitamins during the treatment helps reinforce the structure of the cornea.

Studies have shown that Corneal Cross-Linking (CCL) treatment has produced highly positive results. Along with CCL treatment, it has been observed that the progression of keratoconus disease significantly halts. This leads to an improvement in visual quality and the regression of the disease.

2. Corneal Intra Rings

For patients who cannot use contact lenses, one of the most important alternatives is the placement of corneal intra rings. The purpose of these rings is to correct the shape of the cornea. Through a procedure performed with topical anesthesia, the shape of the cornea can be improved to some extent, leading to better vision. These rings placed in the eye can be removed later at the patient’s request.

3. Corneal Transplantation

Corneal transplant is the latest method for keratoconus. Thanks to this highly prevalent method, tens of thousands of people overcome this problem every year. In the initial stage of corneal transplantation, a donor must be found. The cornea, which has taken on a cone-like shape through surgical intervention, is removed from its place and replaced with a new cornea. Since the cornea does not have a blood connection with the body, it does not need to be of the same blood type as the recipient. Corneal transplantation is generally a successful transplant procedure.

I’ve had this problem of eye floaters for 15-20 years. I saw this treatment on a television program. I didn’t know there was a laser treatment before. I learned that it is treated with vitreolysis for those like me who have this problem in their eyes. After that, it caught my interest.

It has been said that there is no cure for the disease

Muharrem Bal, who stated that he visited many doctors in Belgium, expressed his disappointment as follows: “When we learned that the treatment for my illness was in Turkey, my wife and I started researching. We went to a doctor in Belgium. The doctor said, ‘It’s not a big deal. You will continue with your life this way. There is no cure.’ I felt disappointed when I heard this. I told my wife, ‘I want to go to Istanbul and get treatment.’ After that, I focused on Istanbul.”

“I believed in Turkish doctors, trusted them. I am very happy.”

Muharrem Bal said, “Atatürk said, ‘Entrust me to Turkish doctors.’ I believed in and trusted Turkish doctors, and now I am very happy. I made an appointment with Prof. Dr. Tayfun Bavbek. Two sessions of treatment were applied to my right eye and three sessions to my left eye. I am very well now. I don’t even have any pain. Previously, when I looked at a wall or anything in the distance, there were lines, dots, or eye floaters in front of my eyes. Now, they are gone. These devices are not available in Belgium. There is not even a diagnosis. If there were, my doctor would have said, ‘It exists in this region; go there,’ but he didn’t. I am glad I got treated in my country.”

Prof. Dr. Tayfun Bavbek: We Eliminated the Floaters

Eye Health and Diseases Specialist Prof. Dr. Tayfun Bavbek from Batıgöz Health Group, who restored Muharrem Bal’s health with the vitreolysis method, said, “Our patient approached us due to floaters in his eyes. He did not have any cataracts, eye pressure, or glaucoma. His retina was also extremely healthy. He expressed to us that these floaters had been bothering him for years; he had visited doctors in Germany, Belgium, Switzerland, and France, but no solution could be found. He mentioned learning that he could get rid of this issue from watching a television program. Upon this, I explained to him that we could vaporize and eliminate these floaters in the eyes with short bursts of high energy using a laser device called vitreolysis. I explained that this is actually due to vitreous shrinkage, which occurs in many people as the gel inside the eye, called vitreous, loses its fluid with age. We treated his right eye with two sessions and left eye with three sessions, eliminating the floaters. Our patient returned to Belgium extremely healthy and happy,” he said.