Cornea & Occular Surface
Dry Eye
Keratoconus
Sutureless Corneal Transplantation

The human eye is one of the most important vital sense organs of the body. The front part of the eye contains a glass like structure called the cornea that allows light to enter the eye and get focused on the light sensitive layer of the eye i.e. the retina. Any factor that affects the health of the cornea leads to degradation of its clarity and thereby directly affects the quality of vision.

The health of the ocular surface is maintained by the tear film, normal functioning eyelids, and healthy population of corneal stem cells. The tear glands continuously produce a watery secretion that moistens and lubricates the ocular surface, allowing smooth movement of the eyelids and the eyeball. The tear film also washes away any debris that accumulates on the surface of the eye, and provides a smooth refracting surface of the cornea.

Any deficiency of a stable tear film, directly affects the quality of vision, besides producing a variety of symptoms. These range from dryness, burning sensation, irritation, foreign body sensation, itching, and redness etc. I am sure as you read this section, you will recall experiencing some of these symptoms in the past. Well with the advent of 24 hours television channels, and usage of computers in day to day work, dry eye syndrome has become quite common, and is often referred to as "Computer Vision Syndrome"

While watching television or working long hours on computer, people tend to blink less frequently. This leads to drying of the ocular surface in between blinks, making the surface rough, with resultant symptoms of irritation and burning etc. Moreover sitting in an air conditioned environment leads to faster evaporation and drying of the eyes. Hence it is important to realize this and consciously blink more frequently, or take a break after an hour, and keep the eyes closed to allow the surface to recover.

Dry eye condition, also leads to poor lid hygiene, due to which there may be recurrent episodes of lid margin infections, painful boils in the eye lids. These often tend to recur if the dry eye condition is not properly treated.

When to see a doctor

Make an appointment for an eye exam if you notice any changes in your vision. If you develop sudden vision changes, such as double vision or flashes of light, sudden eye pain, or sudden headache, see your doctor right away.

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But it is extremely important to remember that all dry eyes may not be a result of infrequent blinking.... There may be an actual reduction in tear production, leading to all the symptoms described earlier. A proper assessment of the ocular surface status by a well trained corneal surgeon is essential to diagnose the exact etiology, and then provide correct treatment to resolve the same.

Frequently dry eye symptoms may be the first indicator of systemic connective tissue disorders or rheumatoid arthritis, so it is important that your corneal surgeon does a proper evaluation to rule out the same. The routine ophthalmologist (eye specialist), may not be able to assess the surface changes in a detailed manner, as compared to a well trained corneal surgeon.

At the dry eye clinic, a detailed history is recorded, followed by clinical tests in a logical sequence, to assess the correct etiology, and severity of the surface damage secondary to dry eye condition.

Proper counseling of the patient is done, following which appropriate dry eye therapy is started. Follow up visits are essential to assess the extent of recovery of the health of the ocular surface. Patients often tend to skip these visits as they get symptomatically better with the medications. Due to this, often it leads to inadequate treatment, and recurrence of symptoms after some time..

Newer medications, can help reduce surface inflammation, & improve the surface sensitivity, which tends to improve tear secretion. This is essential to restore the health of the ocular surface and reduce patient symptoms, and dependence on artificial tear drops.