The cornea is the front window of the eye, like the windshield of your car.  It is amazing that the body can produce tissue that is perfectly clear.  The shape of the cornea helps to bend and focus the light rays as they enter the eye.  There are three main layers to the cornea and different diseases can affect each layer.  The outer layer is the epithelium.  This thin layer of skin is so thin that it remains clear.  A corneal abrasion develops when this thin skin is scratched away from the cornea.  This can be very painful because there are hundreds of small nerves that are exposed when the epithelium is gone.

The stroma is the thickest part of the cornea (but is still very thin – only ½ of a millimeter).  This structure gives the cornea its amazing strength.  Injuries to the cornea lead to scarring which cause the tissue to become white and cloudy.  The only way to remove this scar is with a corneal transplant surgery.

The endothelium is the thin inner lining of the cornea.  This layer has a special function to pump fluid out of the stroma.  If these cells get damaged and lose their ability to pump, the cornea becomes swollen (called edema).  A swollen cornea also becomes white and cloudy and causes decreased vision.  To fix this condition a partial cornea transplant (DSEK procedure) surgery can be done to implant new healthy endothelial cells into the eye.

A laser can be used to change to shape of the cornea.  This can help you to see better without glasses or contact lenses (called refractive surgery).  The laser can be applied to the surface of the cornea (PRK – photo refractive keratomeilusis) or applied under a thin flap of stroma (LASIK – Laser assisted).

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