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Ophthalmology
Published in Keith Hopcroft, Instant Wisdom for GPs, 2017
Individuals may have a history of a prior corneal injury recently or even many years back, though they may have to think hard to remember it. Typically, patients wake up and, as they open their eyes, the corneal epithelium ‘sloughs’ off. As the cornea is heavily innervated, the result is severe pain and a foreign body sensation. The treatment is topical antibiotics and lubricants. If it persists, consider referring to ophthalmology, as phototherapeutic keratectomy (PTK) laser can help strengthen the corneal bonds. Patching the eye is a very simple but effective pain control method, as is the use of dilating agents such as cyclopentolate drops.
Effect of Solution pH on the Biomechanics of Intact Cornea From Inflation Tests
Published in Current Eye Research, 2023
Yining Guo, Yuexin Wang, Jiahui Ma, Xuemin Li
Previous research revealed that corneal elastic modulus was associated with corneal edema following the phototherapeutic keratectomy.23 Studies have shown that the corneal hysteresis decreases in edematous cornea postoperatively.24,25 The present research used the inflation test and manifested that the corneal modulus significantly decreased, and the CCT increased following the administration of PBS at various pH values, which was not observed in the control group. The results indicated that the increasing hydration induced the diminishment of the corneal stiffness to the posterior pressure. The biomechanical properties of the cornea are mainly determined by the corneal stroma, which is largely comprised of collagen fibrils and proteoglycan.26 The administration of various pH PBS solution might induce the absorbance of water into the corneal stroma. Following hydration, the low-viscosity water absorbed into the stroma diluted the organization of the extracellular matrix, causing a reduction in the viscosity and stiffness of the cornea.27
Pharmacological treatment for transforming growth factor beta induced corneal dystrophies: what is the way forward?
Published in Expert Review of Clinical Pharmacology, 2023
Gabriella Guo Sciriha, Janet Sultana, Joseph Borg
Presently, there is no treatment for TGFBI CDs that acts by targeting the disease pathology. Individuals suffering from these dystrophies may experience painful recurrent epithelial erosions that are initially managed with lubricant drops and bandage contact lenses to relieve discomfort. In severe cases, superficial keratectomy or laser phototherapeutic keratectomy can be applied. Visual acuity deterioration is managed by corneal graft surgery that includes lamellar keratoplasty or full thickness penetrating keratoplasty, which, besides being associated with a number of serious complications, is temporary, since recurrence is high [5]. Researchers are continuously attempting to discover less invasive non-surgical treatments with the aim of preventing or stopping the deposition of corneal complexes in the early stages of CDs. One significant hurdle encountered in the development of topical medications used in the treatment of anterior segment eye conditions is the physiological barrier present in the cornea that can decrease the efficacy of medications significantly. Having said that, novel ophthalmic formulations that prolong the time of corneal exposure to the drug or increase corneal permeability are currently being tested [6].
Effects of Superficial Keratectomy in Peripheral Hypertrophic Subepithelial Corneal Opacification on Front and Back Corneal Astigmatism
Published in Current Eye Research, 2021
Jana C Riedl, Alexander K Schuster, Aytan Musayeva, Joanna Wasielica-Poslednik, Susanne Marx-Gross, Adrian Gericke
Peripheral hypertrophic subepithelial corneal opacification (PHSCO) was first described by Maust and Raber in 2003.1 PHSCO is characterized by solitary or multiple bluish-white elevations, rising above the corneal surface.2 Histologically, superficial fibrosis is located between the corneal epithelium and the Bowman’s layer. This leads to an increased whole corneal thickness in affected areas and to changes of the anterior corneal surface.2,3 Foreign body sensation and reduced visual acuity due to progression of the opacification towards the corneal center as well as progressive irregular astigmatism are the main reasons for patients´ dissatisfaction. No spontaneous remission has been reported in PHSCO so far. Superficial keratectomy or phototherapeutic keratectomy (PTK) are potential treatment options. It is still heavily debated whether PHSCO belongs to the same clinical entity as Salzmann’s nodular degeneration.4 Both diseases are usually characterized by uni- or bilateral moderate peripheral to mid-peripheral corneal hypertrophic opacification spots and affect primarily middle-aged women.5 The largest disagreement between PHSCO and Salzmann’s nodular degeneration is the implication of inflammation or trauma in the pathophysiology of Salzmann’s nodular degeneration, which does not apply to PHSCO. Furthermore, PHSCO is often associated with corneal vascularization and changes in the posterior corneal surface.4,6