Corneal disease treatments
Corneal dystrophy, Fuchs’ dystrophy, keratoconus, corneal inflammation and injury
Corneal disease can severely affect your vision if not treated promptly and effectively. Duke corneal specialists in Durham, Raleigh, and Cary provide treatment for a variety of corneal diseases, including corneal dystrophies such as Fuchs’ dystrophy; corneal inflammation, scarring, and ulcers; dry eye; and keratoconus. If your condition has progressed to the point where you need corneal transplant surgery, we offer both full- and partial-thickness corneal transplants as well as artificial cornea placement.
When do you need a corneal disease specialist?
If corneal disease or injury is affecting your vision or eye health, it’s important to trust your care to a trained specialist.
- 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.
- For younger patients, our pediatric ophthalmologists are experienced in providing for the unique vision and eye health needs of infants and children.
- 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.
- 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.
- 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.
- 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 keeps the structural integrity of your eye, allows you to recover faster, and can minimize your risk of rejection.
- 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.
- 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.
- PATIENT STORYCorneal Transplant Advances Improve Vision
I trusted Dr. Gupta so I agreed to let her try this new approach. My recovery was quicker.
CORNEAL DISEASE
Treatments
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Our doctors may prescribe antibiotics, antivirals, or antifungal medications if you have an infection caused by bacteria, virus, or fungus. Some of these medications are specially compounded in our own Duke specialty pharmacy.
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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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This in-office procedure for keratoconus uses vitamin B2 (riboflavin) and UV 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.
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Small, circular, corneal rings -- called Intacs – are implanted in the eye to correct irregular-shaped corneas and improve vision impaired by keratoconus.
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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. Recuperation takes days, as new tissue grows over the corneal surface.
CORNEAL DISEASE
Tests
Your corneal surgeon will conduct a thorough examination of your eye and its structures using a variety of imaging devices to help diagnose any corneal disorders or diseases.
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This gives your doctor a magnified, 3-D view of the structures at the front of your eye.
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A computer-guided device creates a 3-D image map of your cornea to measure corneal power, curvature, and thickness.
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Ultrasound waves measure the thickness of your cornea.
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Measures the curvature of your cornea’s front surface to assess astigmatism.
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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.
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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.
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Allows your doctor to examine the cellular structure of your cornea and to see normal and abnormal cells in the various corneal layers (epithelium, Bowman’s layer, stroma, Descemet’s membrane, and endothelium) as well as infectious cells such as fungi and amoeba.