Corneal Disease Treatments

Corneal Dystrophy, Fuchs’ Dystrophy, Keratoconus, Corneal Inflammation and Injury

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Overview

The cornea is the clear outer layer at the front of your eye. It helps your eye focus light so that you can see clearly. Corneal disease can severely affect your vision if not treated promptly and effectively. Duke corneal specialists throughout the Triangle provide treatment for a variety of corneal diseases. Some of these include corneal dystrophies such as Fuchs’ dystrophy; corneal inflammation, scarring, and ulcers; dry eye; and keratoconus. If your condition has progressed and you need corneal transplant surgery to help restore you vision, we offer the most advanced surgical techniques that replace the affected layer of the cornea -- maximizing your vision and minimizing risks and recovery time.

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Treatments for Corneal Disease

Treatments Overview

There are a multitude of treatments for corneal disease (also called ocular surface disease). They may include glasses, custom contact lenses, over-the-counter eyedrops, specially formulated medications, in-office laser surgery, or corneal transplantation. Your cornea specialist has completed additional years of training in these specific areas and will make a detailed plan specific to your condition.

Medical Management

Description

Our doctors may prescribe antibiotics, antivirals, or antifungal medications if you have an infection. Some of these medications are specially compounded in our own Duke Specialty Pharmacy. We can also create biologic tear replacement therapies for severe ocular surface disease.

Corrective Lenses

Description

If your corneas are irregularly shaped due to keratoconus, or if you have severe ocular surface disease, we can custom fit you for vision-correcting hard contact lenses, known as scleral contact lenses.

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Duke Health offers locations throughout the Triangle. Find one near you.

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Collagen Cross-Linking

Description

This in-office procedure for keratoconus -- a thinning and bulging of the cornea -- uses vitamin B2 (riboflavin) and ultraviolet light to strengthen structural proteins in your cornea and stop disease progression. It can stabilize your vision and prevent you from needing a corneal transplant.

Intracorneal Ring Segments

Description

Small, circular, corneal rings -- called Intacs -- are implanted in the eye to correct irregular-shaped corneas and improve vision impaired by keratoconus.

Phototherapeutic Keratectomy (PTK)

Description

A laser beam removes corneal irregularities, scars, and diseased tissue from the surface of the cornea. PTK can also be used to reshape the cornea to improve vision.

Tests for Corneal Disease

Tests Overview

Your corneal surgeon will conduct a thorough examination of your eye and its structures.

Slit Lamp Exam

Description

This test gives your doctor a magnified, 3D view of the structures at the front of your eye.

Corneal Topography and Tomography

Description

A computer-guided device creates a 3D image map of your cornea to measure corneal power, curvature, and thickness.

Corneal Pachymetry

Description

Ultrasound waves measure the thickness of your cornea.

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Keratometry

Description

This test measures the curvature of your cornea’s front surface to assess astigmatism.

Tear Film Interferometry/Meibography

Description

This non-invasive imaging technology helps your doctor assess the oil (lipid) layer of your tear film, as well as the anatomy and structure of the oil-producing glands in your eyelids. This can help determine the cause of dry eyes.

Optical Coherence Tomography

Description

OCT is a non-contact imaging test that uses light waves to take high-resolution, cross-sectional pictures of your cornea. These images can be used to examine changes to the normal layered anatomy of the cornea.

In-Vivo Confocal Microscopy

Description

Allows your doctor to examine the cellular structure of your cornea and to see normal and abnormal cells in the various corneal layers as well as infectious cells such as fungi and amoeba.

Best Eye Hospital in North Carolina

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our ophthalmology program is ranked sixth in the nation and is the highest ranked program in North Carolina, according to U.S. News & World Report for 2022–2023.

Why Choose Duke

Content

Advanced Training in Corneal Disease Management
Duke corneal surgeons are board-certified ophthalmologists with advanced training in the medical and surgical management of corneal disease. Our surgical expertise and access to the most technically advanced equipment ensure that you receive an accurate diagnosis and the most effective treatment plan.

Noninvasive Diagnostic Imaging Techniques
You’ll have access to noninvasive diagnostic imaging techniques that allow our doctors to look at your corneas and surrounding structures in high resolution. This helps us identify and assess corneal diseases such as ocular surface tumors, corneal infections, and dry eye.

Access to Advanced Dry Eye Treatments
To diagnose the cause of your dry eyes, we use advanced testing and imaging. You’ll also have access to advanced dry-eye treatments, including anti-inflammatory agents, thermal pulsation therapy, autologous serum tears, and scleral contact lenses.

Collagen Cross-Linking Treatment for Patients with Keratoconus
If you have keratoconus, you may be a candidate for the first FDA-approved collagen cross-linking treatment, which can stop the condition from progressing and prevent you from needing a corneal transplant.

Latest Corneal Transplant Techniques
If you need corneal transplant surgery, we offer the latest corneal transplant techniques to remove only the diseased portion of your cornea, rather than all the layers of the cornea. This preserves the structural integrity of your eye, allows you to recover faster, and can minimize your risk of rejection.

Artificial Cornea Implants
If you have not had success with standard corneal transplants, you may be a candidate for artificial cornea implants (keratoprosthesis). We are one of the few eye centers in the region with expertise in this procedure.

Specialized Care for Infants and Children
For younger patients, our cornea specialists partner with Duke pediatric ophthalmologists who are experienced in meeting the unique vision and eye health needs of infants and children. We use a team approach to help your child develop the best vision possible.

Patient Support Services
You can also benefit from our patient support services, including educational materials and programs, a low vision rehabilitation program, and a dedicated social worker to help you and your loved ones manage your condition and maximize your quality of life.

This page was medically reviewed on 07/07/2020 by

Melissa B. Daluvoy, MD | Corneal Specialist