Corneal conditions

CORNEAL SCARS AND SWELLING

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CORNEAL CONDITIONS EXPLAINED

In these toggles we explain what you need to know about corneal conditions

Corneal swelling, or corneal edema, is most common in individuals who are the age of 50 or older, although the eye condition can occur at any age.

The inner layer of cells in the cornea is called the Endothelium. These cells are important because they prevent fluid from accumulating in the cornea. However, they are sometimes not able to perform this function properly.

If the Endothelium cells do not function correctly, the natural water of the eye seeps into the cornea causing it to swell. This can cause symptoms such as glare from lights and blurred vision.

This problem may occur due to a condition called Fuchs’ Endothelial Dystrophy. Fuchs’ Endothelial Dystrophy can be due to genetics in some cases but usually occurs as a result of growing older.

Cataract surgery can also cause the cornea to swell with fluid, which takes a long time to clear or may sometimes fail to clear. This can occur if the cataract removed was very dense, if the surgery was prolonged, or if the eye had changes of Fuchs’ Endothelial Dystrophy initially.

Prof Muhtaseb will conduct a thorough examination of your eyes, and explain in detail all the risks and benefits of this surgery.

You will have ample opportunity to ask questions.

The treatment for this problem is a type of corneal transplant operation in which the endothelial cells are removed and replaced using donor cells. This is a partial layer corneal transplant operation and is much better than the full thickness transplant that used to be performed up until a few years ago.

If you have Fuchs’ Endothelial Dystrophy and a cataract, then Prof Muhtaseb can perform a combined operation to remove your cataract and complete the endothelial transplant in a single procedure.

Watch this video on Endothelial Keratoplasty (DSEK):

How urgently should I think about having surgery to treat the corneal swelling?

This depends on:

  • The degree of the swelling
  • What is causing it
  • The duration you have had the problem
  • The effect it is having on your vision

If you have mild swelling that is not causing much trouble with the vision, we can observe this over time in the clinic. If the swelling is severe and your vision is greatly reduced, we will need to discuss the risks and benefits of surgery.

My optician says I have a cataract, but there are also changes in the cornea that may get worse if I have the cataract operation. What should I do?

I recommend coming in for an examination and detailed discussion with Prof Mohammed Muhtaseb. He will be able to take you through the pros and cons of every option, whether that is deferring or going ahead with cataract surgery.

It can be possible to perform cataract surgery and achieve a good degree of improved vision even when other corneal changes are present.

It is also possible to combine the cataract operation with the corneal transplant operation if it is clear that both surgeries are required.

A detailed discussion with Prof Muhtaseb will highlight all the issues that need to be considered.

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You’re over 45 and would love to read again without glasses

Unfortunately, reading glasses or varifocals get in the way of many of the things you most enjoy. Yes, spectacles help, but they are annoying little appendages that you lose or must clean to see clearly.

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The effect on your life can vary from being slightly frustrating, through to significantly affecting your ability to function independently, or even causing a devastating reduction in vision.

Before you developed cataracts, you were living a full life. You may enjoy the outdoors, have indoor hobbies or enjoy travelling. Or, perhaps you have finished working and are now taking the time to enjoy everything you may have missed when you were busy making a living.

Sadly, your eyes now dull the shine of life’s beautiful landscape. The trees, the flowers and even the sky don’t seem as bright as they used to look.

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“I would like to thank you most sincerely for the laser surgery you performed to improve my eyesight. It really has improved the quality of my life and I feel like a new person.”
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R M, Refractive Surgery

“I was given a choice of lenses and detailed information before making my decision. I am now able to drive and read without glasses. It was entirely painless and the care I received before and after the procedures was excellent.”
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Mr. C P, LASIK

“I am very happy with Mr Muhtaseb’s professional, detailed and careful approach to my surgery. I have had successful surgery and am very happy with the result. This has been a life changing surgery for me.”
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Professor H J, Refractive Surgery

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Mrs. S G, Multifocal Intraocular Lens

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D R, Refractive Lens Exchange

“Thank you for taking such good care of me during my LASIK surgery – I was terrified! I am so pleased with the outcome, which was pretty much instant – it has made such a difference to my life not having to wear glasses all the time.”
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Mrs. A L, LASIK

“Many thanks to you and your team for all the kindness, care and expertise shown to me when having my cataracts removed. It is lovely to have a new lease of life.”
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Mrs. A D, Refractive Lens Exchange

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C H, Multifocal Lens

“I made my highest break in years last week. It was 137!”
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Anonymous, Multifocal Piggyback Lens
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ABOUT THE EXPERT

Prof Mohammed Muhtaseb, FRCOphth

Consultant Cornea, Cataract and Refractive Surgeon

iLase is the private practice of Consultant Ophthalmic Surgeon, Prof Mohammed Muhtaseb. Based in South Wales, he is one of the very few ophthalmologists working in the UK who is a fellowship-trained specialist in Cornea, Cataract and Refractive Surgery. He holds full specialist registration with the General Medical Council and was appointed as a Consultant in the NHS in 2006.

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