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Astigmatism is irregularity of the cornea that may result in blurry vision at all distances. Although most patients have a small amount of astigmatism, moderate to severe astigmatism can greatly impair visual quality. Regular astigmatism is usually treated with spectacles or toric soft contact lenses. High or irregular astigmatism may require the use of hard/rigid contact lenses. Severe cases of astigmatism should be evaluated by a cornea specialist for a cornea abnormality such as keratoconus, corneal ectasia, pellucid marginal degeneration, epithelial basement membrane dystrophy / map-dot-fingerprint dystrophy, or corneal scarring. Many patients with astigmatism are good candidates for LASIK, PRK/surface ablation, or cataract surgery with an astigmatism-correcting (toric) lens. Ask your surgeon which treatment is best for you.

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The human lens is a clear structure in the eye that is directly behind the pupil. The lens is clear and works to focus light as it passes from the cornea to the retina. Over time, the human lens becomes cloudy, which commonly causes blurry vision, glare with bright lights, and difficulty reading in dim environments. Although this is a normal change of aging, sometimes cataract can also be caused by eye injury, the use of steroid medications, chronic allergies, chronic inflammation in the eye, previous eye surgery, or may be associated with illnesses such as diabetes or myotonic dystrophy. The treatment for cataracts is surgical removal with implantation of an intraocular lens. The intraocular lens can be used to correct your vision in a number of different ways. Most patients choose a lens that focuses their vision in the distance and they use reading glasses to see fine print. Some people choose more advanced correction with options that include lenses that correct astigmatism (toric), lenses that provide a monovision target with one eye focused far and the other focused for reading, or multifocal lenses that give a range of vision and thus reduce the need for reading glasses.

Fuch’s Dystrophy

The cornea has the unique function of maintaining visual clarity while also maintaining direct contact with the outside world and the liquid within the eye. The cornea accomplishes this by a steady flow of tears which nourish the surface of the cornea, a regular precise arrangement of collagen within the body “stroma” of the cornea that are spaced in a way that allows light to pass without being reflected or absorbed, and by the specialized endothelial cells on the back surface of the cornea which are constantly removing water from the cornea to prevent swelling and haze, which would interfere with vision. In Fuchs corneal dystrophy, the endothelial cells do not function normally. The abnormal endothelial cells create elevated bumps on their basement membrane, the “Descemet membrane.” These bumps, called guttae, may cause light scatter and reduce visual quality resulting in difficulty reading fine print, seeing in low-light environments, and driving at night. Fuchs corneal dystrophy is also associated with the gradual loss of endothelial cells over time, which results in corneal swelling and haze (scarring) in more advanced cases of the condition. Patients with Fuchs dystrophy are at greater risk of complications and corneal edema following many types of eye surgery, including cataract surgery and LASIK.

The primary treatment for Fuchs corneal dystrophy is corneal transplant. Previously, the only form of transplantation was full-thickness transplant of the entire cornea, or penetrating keratoplasty. This older transplant technique had a long recovery period and a significant risk of complications. Newer techniques of selective partial corneal transplant pioneered at the Devers eye institute have become the standard treatment for Fuchs corneal dystrophy. These newer techniques, which include DSAEK and DMEK, are associated with much faster visual recovery, better visual acuity after surgery, and a lower risk of vision threatening complications.

Ask your surgeon if you are a candidate for DSAEK or DMEK selective corneal transplant.

DMEK + Ripasudil Clinical Trial

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Keratoconus is a progressive degenerative disease in which the cornea becomes thinner and looses it shape.  The cornea slowly becomes  cone shaped. Thus the name: KERATO  (cornea) and KONUS (cone shaped).

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Dry Eye

Dry eye is a multifactorial syndrome that affects the ocular surface, it can be caused by an imbalance in the tear production or the outflow system of the eye, it can have an evaporative component or a lack of quality tears. It can cause red eye, irritation, discomfort, inability to wear contact lenses, and even pain and blurry vision.

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