Research Paper: Corneal Degeneration

Corneal degeneration is the health problem affecting the elderly population mainly. Women are more likely to suffer from corneal degeneration compared to men. Causes of corneal degeneration are not always clear. The major causes of the health problems may be environmental factors, infections, traumas, chronic ocular surface inflammation, corneal ulcers and others. If corneal degeneration remains untreated remains untreated, the health problem may result in the blindness of the patient. The treatment of the health problem normally includes the management of the underlying etiology, eyelid hygiene, the use of contact lenses, medical management. The surgery is applied in the most severe cases but normally the condition may be managed without surgery. The early diagnosis is important to start medical management and prevent the surgery. Surgeries are normally successful and do not cause Research Paper: Corneal Degeneration

Corneal degeneration is a serious condition that affects the elderly population mainly and occurs frequently in the result of the aging. The steady corneal degeneration may be accelerated by environmental factors as well as by infections or corneal ulcers and other factors. In fact, the cause of the corneal degeneration cannot be always determined accurately. At the same time, the treatment of the condition is essential because, in the most severe cases, the corneal degeneration may lead to the complete blindness of patients. In this regard, the early diagnosis of the health problem can help to start the treatment at the early stage and to slow down the development of the disease. At this point, it is worth mentioning the fact that the treatment of the health problem may involve different methods but, in the most dangerous and severe cases, the surgery is required. However, the surgery is normally successful does not cause any consistent negative side effects or complications. In such a situation, the treatment of corneal degeneration turns out to be essential. In fact, corneal degeneration is a serious condition that may threaten to the patient’s vision and lead to the complete blindness of the patient that makes the early diagnosis of the illness crucial for the successful treatment and prevention of the surgery.Research Paper: Corneal Degeneration

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Background

Corneal degeneration involves the steady destruction or degeneration of cornea. Corneal degradation is a relatively slow process that may takes years and normally the health problem emerges in the elderly population. Corneal degeneration is characterized by bilateral gray-white elevated nodules anterior to Bowman’s layer, which may be visually significant, cause foreign body sensation, or be asymptomatic. It is most common in middle-aged women (Wang, et al., 2006). At the same time, this health problem may occur in male patients too. The distinct feature of the patient population is the age since normally this health problem does not occur to young patients. Carnea is normally maintained in a good shape for a long time but the process of degeneration is natural and accompanies the aging of patients. In the course of aging, cornea becomes sinner and sinner and steadily degenerates that increases the risk of the total degeneration of cornea that results in the blindness of the patient. In this regard, it is worth mentioning the fact that corneal degeneration can affect both eyes as well as one eye of the patient, depending on the cause of the health problem. For instance, if the major cause of the health problem is the aging and corneal degeneration occurs in a natural way under the impact of the steady destruction or degeneration of cornea, then both eyes of the patient may be under a threat because degeneration process occurs relatively proportionally in both eyes. At the same time, if the cause of corneal degeneration is an infection or trauma affecting one eye only, the health problem may affect the injure or infected eye only. Nevertheless, in all cases corneal degeneration needs the treatment being implemented as soon as the health problem is diagnosed.

Diagnosis

The diagnosis is normally made on the basis of the characteristic clinical appearance and the clinical history of progressive increasing irregular astigmatism associated with worsening of best corrected visual acuity (Wang, et al., 2006). The loss of the visual acuity is the direct indication to the corneal problem. However, before the examination of the patient’s eye, it is possible to notice early signs of corneal degeneration. In this regard, it is worth mentioning that corneal degeneration manifests through early signs of visual impairment, such as unclear vision, especially in the morning, aching eyes, possible visual changes in the eye. However, the best way to diagnose the health problem is to refer to a health care professional, who can detailed examination and analysis of the current condition of cornea and determine whether cornea degeneration becomes dangerous for the condition of the patient or not. If the dangerous level of cornea degeneration is diagnosed the health care professional determines the treatment respectively to the progress of the health problem Research Paper: Corneal Degeneration

At this point, it is worth mentioning the fact that regular examination should be efficient preventive measures to stop the accelerated corneal degeneration. If patients conduct regular examinations, health care professionals can measure the cornea level and notice considerable changes in the degeneration of cornea. On the other hand, younger patients should not worry about the risk of the development of corneal degeneration because they are not vulnerable to the development of this health problem, unless they feel discomfort or problems with their vision. In such a case, they should definitely refer to a health care professional and consult their doctor to conduct the detailed examination of the eye.

Causes

The cause of this degeneration may be unknown. In fact, causes may vary and a combination of factors may cause the development of the health problem. In case of corneal degeneration, the identification of the cause of the health problem is important but not crucial since the treatment focuses on the treatment of the current condition of the patient and specific problem diagnosed in the particular patient. However, the health problem is often associated with chronic ocular surface inflammation (Wang, et al., 2006). The inflammation causes the fast corneal degeneration. If the problems remained undiagnosed, the condition of the patient may deteriorate consistently in a short time. In case of the inflammation, the treatment is essential and the treatment should start immediately. At the same time, the inflammation also has its caused and the most common associations are, in descending order, meibomian gland dysfunction (MGD), contact lens wear (especially hard contact lenses), peripheral vascularization, pterygium, keratoconjunctivitis sicca, and exposure keratitis (Cunningham, et al., 2001). In fact, all these factors should be taken into consideration while diagnosing corneal degeneration.Research Paper: Corneal Degeneration

At the same time, health professionals do not normally have any considerable problems with the diagnosis of corneal degeneration. The examination of the eye and the condition of cornea reveals whether the degeneration has already had a distrustful impact on cornea or not. Depending on the diagnosis and the progress of the health problem, the health care professional can take a decision on the further treatment of the patient.

In addition, corneal ulcers are another possible cause of corneal degeneration. They can be caused by bacterial, fungal, or viral infection, or by injury to the cornea. Staphylococcus and streptococcus bacteria, the herpes simplex virus, and yeast infection are all common causes of corneal ulcers. Corneal ulcers cause both impaired vision and intense pain. If untreated, they can lead to scarring and eventually to blindness (Wang, et al., 2006). In fact, corneal ulcers may be a serious factor that causes corneal degeneration because they affect the eye and destroy cornea. At any rate, corneal ulcers speed up the process of degeneration consistently. In such a way, patients may suffer from the fast deterioration of their vision and fast progress of corneal degeneration, if they suffer from corneal ulcers.

Furthermore, environmental factors, such as trauma, viral infection, glaucoma, and other factors may also cause the corneal degeneration (Cunningham, et al., 2001). The impact of environmental factors should not be underestimated at the stage of diagnosis of corneal degeneration. Today, patients are vulnerable to the impact of multiple environmental factors. In this regard, elderly patients should be particularly aware of the risk of corneal degeneration.Research Paper: Corneal Degeneration

Treatment

Today, health care professionals use different methods of the treatment of corneal degeneration. At this point, it is worth mentioning the conservative treatment which consists of management of the underlying etiology, such as MGD. Eyelid hygiene and doxycycline may be considered to treat the MGD prior to surgical treatment. Contact lens cessation or re-fitting may also be beneficial. Medical management is successful in preventing the need for surgery in most cases (Cunningham, et al., 2001). Such a complex treatment can have a positive impact on the condition of the patient to the extent that the surgery will be unnecessary at all. However, in the most severe cases, the surgery is inevitable.

At this point, it is worth mentioning the fact that indications for surgery are (1) discomfort; (2) reduced vision due to progressive increase in astigmatic error. Surgery is uniformly successful in removal of the nodule and almost invariably successful in reducing the astigmatic error in allowing for improvement in best corrected visual acuity, usually with a much weaker spectacle prescription.  If the health care professional diagnoses all these indications, the surgery is highly recommendable.

However, surgery does not cause any substantial complications. Stabilization of the refractive error usually takes 3 to 6 weeks. In rare cases of neglected nodules within the visual axis, anterior stromal haze may compromise the final visual results. The rehabilitation period is relatively short run. Therefore, the surgery is an efficient and safe method of the treatment of corneal degeneration.Research Paper: Corneal Degeneration

Conclusion

Thus, corneal degeneration is a serious health condition which affects consistently elderly patients, especially females. The diagnosis of the health problem at the early stage may be very helpful to start treatment and to avoid surgery. If the condition remains untreated, the patient may become blind.

References:

Cunningham, E.T. et al. (2001). “Blindness: A Global Priority for the Twenty-First Century,” Bulletin of the World Health Organization. 79(3), 180-189.

Wang, H. et al. (2006). “Migration and Proliferation of Retinal Pigment Epithelium on Extracellular Matrix Ligands,” Journal of Rehabilitation Research & Development. 43(6), 713-725.Research Paper: Corneal Degeneration