Keratoconus Health Dictionary

Also known as keratoplasty. If the cornea (see EYE) becomes damaged or diseased and vision is impaired, it can be removed and replaced by a corneal graft. The graft is taken from the cornea of a human donor. Some of the indications for corneal grafting include keratoconus (conicalshaped cornea), corneal dystrophies, severe corneal scarring following HERPES SIMPLEX, and alkali burns or other injury. Because the graft is a foreign protein, there is a danger that the recipient’s immune system may set up a reaction causing rejection of the graft. Rejection results in OEDEMA of the graft with subsequent poor vision. Once a corneal graft has been taken from a donor, it should be used as quickly as possible. Corneas can be stored for days in tissue-culture medium at low temperature. A small number of grafts are autografts in which a patient’s cornea is repositioned.

The Department of Health has drawn up a list of suitable eye-banks to which people can apply to bequeath their eyes, and an o?cial form is now available for the bequest of eyes. (See also DONORS; TRANSPLANTATION.)... corneal graft

The transparent thin-walled dome that forms the front of the eyeball. The cornea is joined at its circumference to the sclera (white of the eye); the black pupil and the coloured iris are visible beneath it. The main functions of the cornea are to help focus light-rays on to the retina at the back of the eye and to protect the front of the eye. It is kept moist by tears produced by the lacrimal gland and the mucus- and fluid-secreting cells in the eyelids and conjunctiva. cornea, disorders of Injuries or diseases affecting the cornea, the outer shell of the eyeball. Injuries include corneal abrasions, which sometimes become infected and progress to a corneal ulcer. Penetrating corneal injuries can cause scarring, which may lead to impairment of vision. Chemical injuries can result from contact with a corrosive substance and require immediate flushing of the eye with water.

In actinic keratopathy, the outer layer of the cornea is damaged by ultraviolet light. In exposure keratopathy, damage is due to reduced protection by the tear film and blink reflex. The cornea can also be infected by viruses, bacteria, and fungi, the herpes simplex virus being especially dangerous. True inflammation of the cornea (called keratitis) is uncommon as the cornea contains no blood vessels.

Other disorders include: keratomalacia as a result of vitamin A deficiency; keratoconjunctivitis sicca (dry eye); corneal dystrophies such as keratoconus; and oedema, in which fluid builds up in the cornea and impairs vision.

Rare congenital defects include microcornea (smaller cornea than normal) or megalocornea (bigger than normal) and buphthalmos, or “ox-eye’’, in which the entire eyeball is distended as a result of glaucoma.

Degenerative conditions of the cornea such as calcium deposition, thinning, and spontaneous ulceration occur mainly in the elderly, and are more common in previously damaged eyes.... cornea

a deposit of iron in the form of a ring in the epithelium of the cornea, which is seen, for example, around the base of the ‘cone’ of the cornea in *keratoconus. It is best visualized using cobalt blue light. [B. Fleischer (1848–1904), German physician]... fleischer ring

n. an abnormal accumulation of fluid in body tissues or cavities. For example, corneal hydrops is the sudden painful accumulation of fluid in the cornea seen in *keratoconus. It results in a sudden reduction of vision. See also hydrops fetalis; Ménière’s disease.... hydrops

(megalocornea) n. a congenital disorder of the eye in which the whole cornea bulges forward in a regular curve. Compare keratoconus.... keratoglobus

(Placido’s disc) n. an instrument for detecting abnormal curvature of the cornea. It consists of a black disc, about 20 cm in diameter, marked with concentric white rings. The examiner looks through a small lens in the centre at the reflection of the rings in the patient’s cornea. A normal cornea will reflect regular concentric images of the rings; a cornea that is abnormally curved (for example in *keratoconus) or scarred reflects distorted rings. Modern keratoscopes can print out a contour map of the corneal surface.... keratoscope