Cornea Diseases2020-06-08T04:46:49+00:00

Corneal disease treatment to help you focus on what matters

HOW WE TREAT CONDITIONS THAT MAINLY AFFECT THE CORNEA
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What is corneal disease?

IN THIS VIDEO I PROVIDE A BRIEF EXPLANATION

Everything you need to know about corneal diseases

IN THESE TOGGLES YOU WILL FIND THE DETAILS YOU ARE LOOKING FOR

Corneal disease refers to many conditions that affect your cornea – the clear window at the front of the eyeball. It is a unique part of the body which is designed to be transparent and crystal clear. You can see the coloured iris and the pupil through the cornea.

The cornea has many functions; one is to help focus light rays on to the retina, the light-sensitive film at the back of the eye to form an image. This image is then transmitted to the brain.

When the cornea is damaged by corneal disease, it can become less transparent, or its shape can change. This can prevent light from reaching the retina and causes the image transmitted to the brain to be distorted or unclear.

Corneal disease can be caused by: 

  • Infectious keratitis
  • Fuch’s endothelial dystrophy
  • Corneal dystrophy
  • Recurrent corneal erosion / corneal abrasion
  • Eye surface tumour
  • Stem cell deficiency

Corneal emergencies

It may be necessary to see a specialist if you experience any persistent or progressive symptoms with your eyes, such as:

  • Red
  • Uncomfortable
  • Painful
  • Sensitive to light
  • Reduced vision

What is Infectious keratitis?

Infectious keratitis is a severe infection of the cornea, the transparent and most anterior part of the eye. It is typically caused by contact lens wear.

How do you treat infectious keratitis?

My expertise in managing eye surface diseases and infections means that you are in the best hands to treat your eye infection.

Early treatment is necessary to prevent any damage to the cornea as an infection could lead to corneal scarring, melting or loss of vision within 48 hours.

I can treat milder infections with intensive drops that you can administer yourself at home. More serious infections may require admission to hospital for intensive day and night eye treatment.

If the vision is severely affected, surgical intervention, lasers and collagen cross-linking may be necessary to manage it.

What is Fuch’s endothelial dystrophy?

Fuch’s endothelial dystrophy is an inherited condition that affects the endothelium, the delicate innermost layer of the cornea. It occurs when the endothelial cells gradually deteriorate over time. Once lost, these endothelial cells do not grow back, leading to the clouding of the cornea, swelling and impaired vision.

In the early stages of the disease, patients experience increased glare and sensitivity to light. As the condition progresses, vision may become blurred in the morning, then sharpen throughout the day. As the condition worsens further, vision may appear blurry throughout the day.

Fuch’s corneal dystrophy affects both eyes and is slightly more common among women than men. It usually starts to develop at around 30 to 40 years of age with no apparent cause.

How do you treat Fuch’s endothelial dystrophy?

Our standard method to treat Fuch’s endothelial dystrophy is endothelial cell transplantation. This is where we take the cells and implant them into the eye. We use two techniques, the descemet’s stripping endothelial keratoplasty (DSEK) or descemet’s membrane endothelial keratoplasty (DMEK).

If the vision becomes severely impaired, a corneal transplant may be required.

What is Corneal dystrophy?

Deposits of various materials within the cornea leads to irregularity in corneal surface and can result in a painful, watery eye from corneal erosions (scratches on the cornea). Sensitivity to light is also a major issue.

Children with corneal dystrophy may struggle to open their eyes in daylight and prefer to sit in the dark. Thye may also experience a lot of glare and halos around lights and objects. In severe cases, it might affect a child’s development and achievement.

In adults, symptoms are more tolerable and often managed conservatively. However, if you progress and develop dense opacities that obscure vision, surgical intervention becomes necessary.

Occasionally the corneal dystrophy is limited to the corneal surface, or it can be deeper in the cornea and lead to a loose corneal surface (skin). If the happens, the eye can become extremely painful.

How do you treat corneal dystrophy?

The management of corneal dystrophies depends on disease severity and which layer/s of the cornea is affected.

The treatment varies from no treatment required to conservative therapies such as using drops to aid cornea clarity, to surgical intervention. Corneal surgery will aim at replacing/ removing the diseased part of the cornea.

At Eye Clinic London, I use modern and advanced lasers to ablate the cornea and clear cornea scarring or other pathologies. This is a delicate and accurate therapy that is applicable where corneal dystrophy or scarring is superficial.

Photo-therapeutic Keratectomy (PTK) is a known successful advanced treatment to treat corneal opacities and pathologies in the upper third part of the cornea. The lasers can precisely excise the lesions from the cornea. Furthermore, corneal transplantation could be required if the corneal pathology extends deeper in the cornea.

We are pioneers in using advanced Femtosecond lasers to precisely cut the cornea and perform superficial or deep anterior lamellar keratoplasty. The procedures are known as Femtolaser enabled Superficial Anterior Lamellar Keratoplasty (Femto-SALK) or Deep Anterior Lamellar Keratoplasty (DALK). If the deepest layer / the lining of the cornea is involved then full thickness corneal transplantation (full thickness corneal graft or Penetrating Keratoplasty (PKP) will be required.

What is recurrent corneal erosion / corneal abrasion?

The thin layer that covers and protects the cornea is called the corneal epithelium. If the cornea is scratched, the eye becomes very red, watery, and painful but tends to heal within 24-48 hours.

As the new epithelium grows, it should stick firmly to the corneal bed underneath it. Occasionally, the new epithelium does not stick very well. This could lead to weakly adherent and loose skin, which is disturbed if you rub your eyes or suffer from dry eye.

The condition can affect both adults and children. It can manifest in children as young as six months. Often it is secondary to congenital corneal dystrophy.

This condition occurs when the eye dries out overnight and is very dry in the morning. The eyelid can get stuck to the skin (corneal epithelium) and slough it away when you open your eyes in the morning. Other causes of recurrent corneal erosion syndrome include congenital corneal dystrophies and diabetes.

How do you treat corneal erosion / corneal abrasion?

Treatment varies from using artificial tears to hypertonic eye ointment to specialised contact lenses. Contact lenses act as a barrier and protect the cornea allowing for good healing underneath it. If this does not work, then the next options are invasive and include:

  • Corneal stromal puncture if the injury is not in the central cornea
  • Alcohol delamination
  • Brushing the corneal surface with a diamond burr
  • Phototherapeutic keratectomy (PTK) which involves using a laser to remove some layers of the cornea.

What is eye surface tumour? 

Tumours of the conjunctiva and cornea are rare. The two most common eye tumours in our clinics are squamous cell tumours and conjunctival melanomas. The first is more common than the second.

Conjunctival melanomas present as brown lesions (occasionally colourless). They often appear on previous flat pigment lesions on the surface of the eye (primary acquired melanosis), or on a pre-existing “freckle” (conjunctival nevus).

An eye tumour could be congenital or acquired and can originate from any layer of ocular surface tissue. Squamous cell tumours are typically caused by sun damage.

At Eye Clinic London, we can tell the difference between a squamous cell tumour and a conjunctival melanoma by the way it looks. However, to be sure, the lesion must be removed and examined by a pathologist.

How do you treat an eye surface tumour?

Treatment of ocular surface tumours consists of surgical removal of the lesion with cryotherapy (freezing treatment) to the surrounding tissues with or without application of cytotoxic medicine. 

Once the eye has healed from surgery, chemotherapy drops may be given to reduce the risk of recurrence of the tumour. Regular follow-up visits with your consultant at the Eye Clinic London are important to determine if the tumor has recurred.

What is stem cell deficiency?

The surface of the cornea is a continuously regenerating surface that is replenished by stem cells. The stem cells are essential to keep the cornea clear and transparent. However, they are very sensitive to the environment and can be damaged by injury, inflammation and infection.

If the stem cells do not replenish to cover the surface of the cornea, this can lead to ocular pain from corneal erosions and decreased vision from stromal scarring or epithelial irregularity.

What is stem cell deficiency treatment?

Treatment of stem cell damage can range from conservative treatment that aims to provide an optimal environment for the remaining survived stem cells. This will involve a wide range of eye products to protect, nourish, and promote healing.

In severe cases, all stem cells can be lost, leading to total stem cell deficiency and loss of corneal clarity, i.e. loss of vision. In this case, stem cell transplantation (SCT) may be necessary to replace the dead stem cells with healthy ones and restore the ocular surface.

Any attempt to restore vision by doing corneal transplantation will fail and lead to further complications. The primary treatment should be restoring a healthy eye surface by transplanting stem cells in the first instance. At a later stage and following the success of stem cell transplantation, corneal transplantation/graft would be a good option to improve vision.

The process of restoring the eye surface, comfort, and improvement of vision will take a long time and involve intensive treatments and multiple surgeries. Additionally, to maximise outcomes of SCT, we use amniotic membrane transplantation and eye surface optimisation protocol, which is unique to Eye Clinic London.

A cornea transplant is an operation to remove all or part of a damaged cornea and replace it with healthy donor tissue.

A cornea transplant is often referred to as keratoplasty or a corneal graft. It can be used to improve sight, relieve pain and treat severe infection or damage. One of the most common reasons for a cornea transplant is a condition called keratoconus, which causes the cornea to change shape.

The type of cornea transplant you have will depend on which part of the cornea is damaged and how much of the cornea needs replacing. The options include:

  • Penetrating Keratoplasty (PK) – a full-thickness transplant
  • Superficial Anterior Lamellar Keratoplasty (SALK)
  • Deep Anterior Lamellar Keratoplasty (DALK)
  • Endothelial keratoplasty (EK) – replacing the deeper (back) layers of the cornea

A cornea transplant can be carried out under general or local anaesthetic. The procedure usually takes less than an hour and depending on your circumstances; you can either leave the hospital the same day or stay overnight.

If the procedure involves the transplantation of the outer cornea, the new outer cornea is held in place with stitches, which usually stay in for at least12 months.

An endothelial transplant doesn’t require stitches. It’s held in place by an air bubble until a few days later when it naturally sticks to the deep layer of the cornea.

In most cases, a cornea transplant procedure lasts less than an hour.

After a cornea transplant

The recovery time for a cornea transplant depends on the type of transplant you have. It takes about 18 months to enjoy the final results of a full-thickness transplant, although it’s usually possible to provide glasses or a contact lens much earlier.

Recovery is usually faster after replacing just the outer and middle layers (DALK). Endothelial transplants (EK) tend to have a faster recovery time of months or even weeks.

It’s essential to take good care of your eye to improve your chances of a good recovery. You should not rub your eye and avoid activities such as contact sports and swimming until we tell you it’s safe.

Are there any risks involved in cornea transplant surgery?

As with all types of surgery, there is a risk of complications. These can include the new cornea being rejected by the body, infection and further vision problems.

Around 95% of full-thickness cornea transplants in low-risk conditions such as keratoconus, last a minimum of 10 years.

Samer Hamada and Eye Clinic London enable Londoners to experience relief from their eye problems so they can focus on what matters most.

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How my eye care services work

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STEP 1: CONTACT US

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STEP 2: LET’S MEET

Visit our clinic in London’s Harley Street district and we’ll conduct a thorough examination and consultation to see if we can help.

STEP 3: FOCUS ON WHAT MATTERS

Have the confidence of knowing that a caring eye care professional is managing your eye condition so you can focus on matters most.

Happy patients from London and East Grinstead

WHAT MY PATIENTS LOVE ABOUT OUR SERVICE

Annabel Giles

“As soon as I met Mr Hamada, I knew I was in safe hands. He is an expert in his field, and very reassuring. His work was impeccable, and I would thoroughly recommend him to anyone wanting a professional, kindly, expert service.”

Tareq Kasshout

“I came all the way from the US to be evaluated by Mr. Samer Hamada who provided me with a world class experience. I was treated with technology that doesn’t exist in the United States. My vision improved significantly since the surgery. Mr. Samer Hamada is definitely a Keratoconus expert.”

Timothy Thompson

“Mr Hamada’s Eye Clinic London and his team are a delight. Nothing was too much trouble and the help, support, advice and guidance before during and after the surgery was all world class. I have worn glasses since the age of 13 years and had the onset of cataracts for the last five so it has all been very much a life changing experience to be free from glasses once more.”

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I AM PROUD TO BE ASSOCIATED WITH THE FOLLOWING ORGANISATIONS

What my patients love about my service

MY PATIENTS ARE MY BEST PROMOTERS

“As soon as I met Mr Hamada, I knew I was in safe hands. He is an expert in his field, and very reassuring. His work was impeccable, and I would thoroughly recommend him to anyone wanting a professional, kindly, expert service.”

Annabel Giles, Lens replacement

“I came all the way from the US to be evaluated by Mr. Samer Hamada who provided me with a world-class experience. I was treated with technology that doesn’t exist in the United States. My vision improved significantly since the surgery. Mr. Samer Hamada is definitely a Keratoconus expert.”

Tareq Kass Hout, Keratoconus
“I am glad to be with Mr Hamada. I am glad to be examined by Mr Hamada who acts responsibly and professionally. I never had this experience before from a previous ophthalmologist. I am thankful to Mr Hamada for the successful diagnosis and treatment of my case.”
Ghiath Sumainah

“What a Consultant. Dr. Hamada is a man who was born for this profession. As soon as we walked into the room you felt that you had met a man who was gentle and kind. His demeanour was of a man who knew his trade. He speaks in a way that you will understand. He explains exactly what is wrong and the way he will help fix it for you.”

Sam Brock

“My eyes got really sore, tired and gritty feeling this year. It kept getting worse for about 6 months and every time I thought about it, I kept thinking it would eventually go away, but it just didn’t budge. So I want to say a big thank you to eye doctor Mr Samer Hamada who finally sorted me out! Apart from the eye tests I expected, he also took a really personal approach. I appreciate that he asked questions about my whole diet and lifestyle which helped him to quickly figure out why my eye surface was inflamed. I now have simple steps I can take to reduce the inflammation through diet and lifestyle changes which I’ve now been doing for 2 weeks. I also have been using the special non-preservative eye drops and gels that Mr Hamada provided. My eyes are already feeling so much better and I’m so relieved to have had help to sort this out. If you’ve been noticing your eyes getting dry – don’t wait to sort it out as it keeps getting continually worse and you can find relief very quickly with the right help.”

Laura Livesey, Dry eye

“Mr Hamada’s London Eye Care and his team are a delight. Nothing was too much trouble and the help, support, advice and guidance before during and after the surgery was all world class. I have worn glasses since the age of 13 years and had the onset of cataracts for the last five so it has all been very much a life changing experience to be free from glasses once more.”

Timothy Thompson

“We saw Mr Hamada after our 14-year-old son was diagnosed with keratoconus by another specialist. Mr Hamada talked us through the pros and cons of the cxl epi off and epi on procedures, he answered all our many and detailed questions without rushing us and as openly and honestly as possible. We opted to go ahead with cxl epi off with Mr Hamada. Our experience with Mr Hamada and his team, from his incredibly informative and supportive Secretary Joanna, nurse Mimi and Mr Hamada himself who was incredibly reassuring and put us and our son at ease both before, during and after the procedure, and at each follow-on appointment, has been the best possible. I would go so far as to say that he and his team are by far the best medical team I have ever experienced. I recommend him highly and would be happy to speak to anyone considering an expert in this field.”

Lisa & George, Keratoconus

“I would not hesitate to recommend Dr Hamada and his team. From the first call to inquire about booking an appointment to booking it, I was so impressed with his wonderful secretary Joanna- she really is worth her weight in gold, her lovely manner and care made me decide to go for this clinic. Dr Hamada was a lovely man with a very kind and thorougher way about him – he put my 4-year-old daughter at ease. The appointment was lengthy but at no point were we rushed and able to ask as many questions- things were explained so well. I would have no hesitation at all to recommend anyone to use Dr Hamada and his team- I have already recommended to some other parents.”

Amy

“Mr Hamada, his assistant Joanna and his ophthalmic technicians provide a caring, efficient and high quality service. From the admin through to the surgical aftercare we were very well looked after and we had a high degree of confidence in Mr Hamada’s abilities. Our daughter’s cataracts have been corrected (under general anaesthetic) and her quality of life has improved substantially. You also feel well cared for throughout – the human touch is vital in healthcare, but not always delivered, so well done and thanks to all of the team.”

Nat & Rich
“We were referred to Dr.Hamada by one of the UK experts. The expert himself admitted that Dr.Hamada was better than him!! We were not disappointed at all. Dr. Hamada was excellent with my child. His communication skills and knowledge were exemplary. He gave us clear management plan and would not hesitate to recommend him.”
V Nama
“Dr Hamada is an excellent, highly competent doctor with a very kind and sympathetic manner. His reputation for successfully treating dry eye patients seems unparalleled. His team are all extremely friendly and helpful, especially Dr Hamada’s PA Joanna, making the overall experience better than anywhere else I’ve been!”
Isla Cully, Dry eye
“Appointment setting and follow-up were very efficient and well managed. Mr Hamada was kind, reassuring, knowledgeable and had a very warm manner with my young son, making him instantly feel at ease. I feel that we can trust him and that he will finally be able to solve my son’s long-term eye problems that have stumped other eye doctors.”
Kathryn
“A real care provider – true in letter and spirit. After having seen few other consultants we were lucky to see Mr. Hamada. He treated my mother’s eyes and the prolonged inflammation finally went away. My mother went on to receive a corneal graft. Mr. Hamada and his clinic are simply wonderful. Their response is immediate every time even if it’s the weekend. Mr. Hamada puts a lot of personal attention answering every question very patiently and alleviating any fears. His manner is so kind that puts his patients completely at ease. This caring trait continues in the rest of his staff especially his assistant Joanna. I really can’t thank them enough. I thoroughly recommend anyone with eye problems to go to Mr. Hamada. You couldn’t be in better hands. He has treated my mother who is a long sufferer of eye problems. I am grateful always to Mr. Hamada and Joanna for all the support they have provided throughout.”
Charmaine Ghafur

We have replaced some of the images of real patients who provided these testimonials to protect their privacy.

Helpful links about corneal disease

COMPREHENSIVE INFORMATION FROM TRUSTED AUTHORITIES

This article goes over the main and most common corneal conditions. Click here for more information.

This article goes over the structure of a cornea and also provides information about symptoms and more. Click here for more information.

If you would like to have a general overview of corneal diseases, this site is worth checking out. Click here for more information.

This site describes what a corneal transplant is, how it is performed, when it is needed, and more. Click here for more information.

Suffering from dry eyes? Take our 2-minute online dry eye assessment to see if we can help alleviate your symptoms and tackle your condition

Take the dry eye self-test

About the expert

Mr Samer Hamada | Consultant Ophthalmologist and Corneal Surgeon

MD, MSc, DO (hons), FRCSEd, FRCOphth I am Samer Hamada, founder and consultant ophthalmic surgeon with over 20 years’ experience in ophthalmology. I am a world-renowned specialist in cornea, cataract and refractive surgery. I’m not only a leading surgeon but also the only dual fellowship trained in corneal diseases in children from reputable institutions in the UK. At Eye Clinic London I work closely with other consultant ophthalmologists, optometrists and orthoptists to achieve the best outcomes for our patients. Our main aim is to make sure our patients get the safest and best treatments available to them. We put your safety before anything else so you can rest assured that if you choose us you will be in the best and safest hands.

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