What is the Cornea?
The cornea is a vital part of the eye that plays a crucial role in focusing light and providing clear vision. Various eye conditions can affect the health and function of the cornea, but several treatment options are available to preserve or restore vision, depending on the specific condition and its severity.
The cornea is a transparent, dome-shaped structure located at the front of the eye. Its primary function is to focus light onto the retina, which lines the back of the eye.
The cornea’s shape and clarity plays an important role in ensuring that light is properly focused, which allows you to experience clear vision. Maintaining the clarity of the cornea is essential for light to pass through uninterrupted and reach the retina.
Many factors, such as age, trauma, or certain eye conditions, can cause the cornea to become hazy, cloudy, or irregularly shaped. Any of these factors can cause blurry or distorted vision.
What Eye Conditions Affect The Cornea?
Several eye conditions can impact the health and function of the cornea. Some of the most common conditions include:
Keratoconus
Keratoconus is a progressive eye condition that causes the cornea to thin and bulge into a cone-like shape. This abnormal shape affects the eye’s ability to focus light properly, leading to distorted and blurred vision.
Symptoms may include increased sensitivity to light, eye strain, and frequent changes in glasses prescription.
Conjunctivitis
Conjunctivitis, more commonly known as pink eye, is an inflammation of the conjunctiva. While it primarily affects the conjunctiva, it can also involve the cornea in some cases.
Pink eye can be caused by viruses, bacteria, or allergens. Symptoms often vary depending on the type and severity of pink eye you have but may include redness, itching, tearing, discharge, and a gritty feeling in the eye.
Dry Eye
Dry eye is a very common eye condition that happens when the eyes do not produce enough tears or when the tears evaporate too quickly. This condition can lead to irritation and inflammation of your cornea.
Dry eye can cause many symptoms including a burning sensation, itching, redness, and a feeling of dryness or grittiness in the eyes.
Herpes Zoster
Herpes zoster, also known as shingles, is an infection caused by the varicella-zoster virus. When shingles affect the face, particularly around the eye, it can cause corneal problems such as inflammation and scarring, resulting in pain, redness, light sensitivity, and blurred vision.
Sometimes, corneal issues can arise months after the shingles rash has resolved. For this reason, those who have experienced facial shingles should always schedule an appointment with their eye doctor to detect and treat potential complications right away.
What Treatments Are Available for Corneal Conditions?
Several treatment options are available for corneal conditions, depending on the specific disorder and its severity. Some of the most common treatments include:
Corneal Transplant
A corneal transplant is a surgical procedure that replaces a damaged or diseased cornea with healthy donor tissue. This procedure is often recommended when the cornea’s condition has deteriorated to the point where it significantly affects vision and quality of life.
Corneal transplants aim to restore vision, reduce pain, and improve the overall health of the eye. At Carolina Cataract & Laser Center, our skilled surgeons perform several types of corneal transplants, including:
Corneal Collagen Cross-Linking (CXL)
Corneal collagen cross-linking, sometimes called CXL, is a treatment that combines special eye drops and ultraviolet light to strengthen the cornea and stop the progression of keratoconus. By creating new corneal collagen cross-links, CXL shortens and thickens the collagen fibrils, resulting in a stronger cornea.
While CXL does not cure keratoconus or improve vision, it can prevent further deterioration and reduce the need for a corneal transplant.
Epioxa
Carolina Cataract & Laser Center is proud to introduce Epioxa, the first epithelium-on (epi-on) corneal cross-linking therapy to receive FDA approval for the treatment of keratoconus. Dr. David Vroman is the first eye doctor in South Carolina to provide this advanced option, making Carolina Cataract & Laser Center (CCLC) among the first practices in the country to bring this therapy to patients. The cornea team at CCLC includes Dr Kristiana Neff, Dr Michelle Ying, and Dr Charlene Grice. All of the doctors perform advanced corneal procedures and will be offering Epioxa.
Like traditional cross-linking, Epioxa uses riboflavin (vitamin B2) eye drops, activated by precisely controlled UV light, to reinforce collagen bonds in the cornea. The important difference lies in how the treatment is delivered: the epithelium, the thin outermost layer of the cornea, remains fully intact from start to finish.
Standard cross-linking requires removing the epithelium before applying riboflavin. While this method has been shown to work, the removal step often leads to pain, light sensitivity, and a recovery period of several days to weeks as the corneal surface regenerates.
Epioxa instead uses an advancedriboflavin formulation engineered to pass through the epithelium on its own, after which UV light is delivered through a specialized system in an oxygen-rich environment.
Keeping the epithelium intact gives Epioxa some clear advantages: a more comfortable healing process, less light sensitivity in the days that follow, and a quicker return to everyday activities. Maintaining the cornea’s natural defensive layer throughout treatment may also reduce the likelihood of certain complications afterward, such as infection and scar formation.
That said, Epioxa is not a one-to-one substitute for traditional epi-off cross-linking, and one is not always appropriate in place of the other. Your doctor will review the details of your situation, taking into account how far the keratoconus has progressed, the thickness of your cornea, and the broader health of your eyes, before recommending a treatment path.
