Corneal problems

The cornea is the transparent, clear front part of the eye through which light enters the eye. This part lies in front of the iris (rainbow membrane). The outer part of the cornea is covered by a thin layer. This is called the epithelium.

There are various corneal problems that you can suffer from. You can get painful, burning and watery eyes from;

• Corneal erosion
•  Trichiasis
• Pinguecula
• Pterygium

Corneal erosion

Corneal erosion is damage to the epithelium of the cornea. Such erosion (or: damage) is painful.

Damage to the cornea can be caused by, for example, wearing contact lenses, a child’s nail, branches or leaves, sand in the eye or by rubbing the eye too hard or after removing a foreign object.

Bacterial ingrowth can cause the cornea to become seriously infected. On the outside there is a white spot on the cornea (also called an ‘ulcer’). The eye produces a lot of discharge, such as yellowish mucus and tears.

Treatment

It is very important to consult an (eye) doctor in case of persistent redness and/or pain lasting longer than 1 day. In this way, it can be recognized in time whether there is a serious corneal infection, for which intensive therapy is necessary.
If a corneal injury occurs, the use of the correct antibacterial eye ointment and an eye bandage is strongly recommended. Usually, approximately 3 days of ointment is sufficient to allow the cornea to heal completely. Sometimes it is necessary to use an eye ointment for several months before going to bed.

Trichiasis

Trichiasis are eyelash hairs that grow inward, causing them to scratch the cornea. The hairs touch the cornea because the upper or lower eyelid has turned inwards or because a hair is growing in the wrong direction. There are several causes for trichiasis, such as:

• age, aging of the tissue in the eyelid causing sagging
• scars on the inside of the eyelid
• convulsive squinting of the eyes
• congenital defect

Hairs scratching the cornea can cause irritation, a sandy feeling in the eyes or sensitivity to light. The eye may also look red. The cornea can become damaged, which can reduce vision or, in the worst case, lead to blindness. If the hairs cause complaints, it is wise to have them removed.

Treatment

If the hairs cause complaints, it is wise to have them removed. The ophthalmologist can use a microscope to make the abnormal hairs visible and remove them permanently. After 8 weeks, a check-up will follow, during which any remaining hairs can also be permanently removed.

Pinguecula

A pinguecula (Latin for: “fat globule”) is a white-yellow swelling in the conjunctiva of the eye, usually on the nasal side of the eyeball. It is in fact not an accumulation of fat but of protein (fragments). It occurs in a large part of the population, more often as people get older and more so in people who spend a lot of time outdoors. It is a benign change of the conjunctiva.

It is usually caused by a combination of aging and exposure to ultraviolet radiation (sunlight, welding).

Treatment

A pingueculum never really goes away on its own. The ophthalmologist can remove the pingueculum from the eye. This is usually done by surgery using a microscope. You will be given an eye ointment bandage for a few days, and after about 1-2 weeks the eye will have healed.

Pterygium

A pterygium (Greek for “wing) occurs when the conjunctiva, which covers the white of the eye, grows in a triangular shape in and over the cornea. Usually a pterygium grows from the nasal side of the eyeball over the cornea. Although there is growing tissue and the treatment sometimes involves radiation, this is not a malignant condition.

Long-term exposure to ultraviolet radiation (from the sun) and chronic irritation of the eyes due to a dusty and dry environment lead to a greater chance of a pterygium growing. It is also seen more often in people who have worked a lot in the open air. Occasionally, a pterygium is a result of inflammation of the cornea and/or sclera.
In most cases, the pterygium is not bothered. Sometimes there is chronic irritation and the eye becomes red at the pterygium. The ingrowth and overgrowth of the cornea can result in an altered cylinder strength of the glasses and reduced vision. If the pterygium is so large that it has grown in front of the pupillary opening, vision will also be reduced. Occasionally double vision occurs due to a pterygium.

If the eye has become irritated (by sunlight, rubbing, swimming or inflammation of the pterygium), it may be necessary to treat with artificial tears or anti-inflammatory drops.
In some cases it is advisable to surgically remove the pterygium.

A pterygium can cause more problems if:

• there is growth over the cornea with increasing cylinder strength
• there is increasing irritation despite drops
• there is growth towards the pupillary edge

Treatment

If the eye has become irritated (by sunlight, rubbing, swimming or inflammation of the pterygium), it may be necessary to treat it with artificial tears and/or anti-inflammatory drops.

In some cases, it is advisable to surgically remove the pterygium. This is done by the ophthalmologist using a special surgical microscope. After removal, the eye usually remains sensitive for 1-2 weeks. You will be prescribed an eye ointment for 3-4 weeks that will speed up recovery.