The cornea protects your eye from contaminants like dust and germs. It also functions as a UV filter to protect your eyes from some of the most damaging ultraviolet rays. It performs the function as the eye’s outermost lens, controlling how much light enters the eye like a window shade. The cornea is also like the lens of a camera in that it focuses the entry of light into the eye. When light hits it, it bends the light into the main lens of your eye which refocuses that light onto the retina at the back of your eye. At Vold Vision in northwest Arkansas, Dr. Steven Vold and Dr. Laura A. Voicu, both certified by the American Board of Ophthalmology make it their mission to care for your corneas with the latest technology and a deep sense of caring.
Corneal Transplant Surgery
"I have been dealing with Glaucoma for the past 25 years. I was put under the care of Dr. Laura Voicu at the Jules Stein Eye Institute at UCLA. She treated me for 18 months and performed Trabeculectomy surgeries on both eyes. Both surgeries were very successful. Dr. Voicuis a very compassionate, knowledgeable, and caring Physician and Surgeon. She is very thorough and carefully explains all aspects of your care. Of the numerous Doctors that have treated my Glaucoma she stands above the rest.Outstanding. I highly recommend Dr. Voicu for the treatment of Glaucoma."- T.D. / Google / Oct 30, 2017
"The after hours Lasik info was GREAT! So glad I went!"- B.A. / Facebook / Dec 01, 2017
"What a great informative event you had! I can’t wait for lasik! Thank you for taking the time to stay and answer all the questions I had!"- C.V. / Facebook / Dec 01, 2017
"I have been to the after hours event twice and it's so great! The staff is amazing, so thorough and helpful! I have only heard amazing things from their patients!"- A.L. / Facebook / Nov 14, 2017
"Getting Lasek was by far the best decision I’ve made regarding my eye health! I? recommend at least getting a consultation to everyone I? know who wears glasses or contacts. It will change your life!"- R.D. / Facebook / Nov 07, 2017
Signs and Symptoms
The cornea’s main job is refraction. As mentioned earlier, it acts as a lens which bends, or refracts light to the retina at the back of your eyeball almost as if the retina were film in a camera. However, with refractive error or corneal disease, the light is bent incorrectly and is not focused exactly on the retinal surface, but before it or after it instead, causing objects to look out of focus, or the image may become dulled or blurred due to a cloudy cornea. If you find yourself experiencing symptoms such as clarity of vision, discharge, itchy or scratchy eyes, contact Vold Vision for a 360-eye exam as soon as possible.
There are a number of eye conditions related specifically to the cornea that can be diagnosed and treated at Vold Vision, including:
Keratitis: This is damage to the cornea that results from infection and /or inflammation. Keratitis can reduce acuity, cause discharge, and erode the cornea. Scarring could also take place, which can harm vision and could ultimately require a corneal transplant.
Dry Eye: People with dry eye produce fewer or lower quality tears so the eyes can’t stay moist enough and ultimately become very uncomfortable. The main symptom is a scratchy or sandy feeling as if something is in the eye. There is a large spectrum of dry eye ranging from simply not making enough tears to moderate and severe ocular surface disease, which involve inflmation and breadown of the ocular surface as well. Dry eye and ocular surface disease are complex problems that need to be diagnosed and treated with attention to detail in order to improve symptoms and vision.
Corneal Dystrophies: There are over 20 corneal dystrophies which may cause clouding of the cornea. Some cause severe problems while others are minor and only caught during a routine eye exam. Others might cause severe pain. Some of the more common dystrophies are: Fuch’s dystrophy, which leads to corneal swelling and may require a corneal transplant, and keratoconus, the most common dystrophy, which may require corneal collagen crosslinking, rigid contact lenses or in advaced cases, a corneal transplant. Other types include Granular, Lattice, and Map-Dot-Fingerprint (or anterior basement membrane) dystrophy.
Herpes Simplex: This extremely common virus can cause cornea pitting and ulceration, inflammation and scarring, as well as damage to other parts of the eye and even elevated eye pressure.
Shingles: Shingles is also a herpes virus that causes problems when the virus that causes chickenpox is reactivated. It can affect the cornea by causing inflammation, scarring and surface ulceration as well as other eye problems.
Pterygium: This is the development of scar tissue from the white part of the eye onto the clear cornea. It can cause astigmatism, corneal warpage and clouding of the vision. Pterygia can be removed and tissue grafts and anti-scarring mediations can prevent regrowth.
Corneal Collagen Crosslinking
Vold Vision is proud to offer corneal collagen crosslinking for keratoconus and corneal ectasia at our Fayetteville, Arkansas location. As the first provider of this service in the NorthWest Arkansas area, we are pleased to announce the minimally-invasive, preventative treatment. Patients no longer need to wait for progression to poor vision to receive treatment for keratoconus. In many cases we may be able to prevent the need for future corneal transplantation or other more invasive treatments due to these conditions with the one-hour treatment. Rarely, crosslinking may be used to treat other eye disorders such as corneal infections.
Cross-linking is a minimally invasive outpatient procedure that combines the use of UVA light and riboflavin eye drops to add stiffness to corneas which have been weakened by disease or refractive surgery. Cross-linking, which has been performed in Europe since 2003, is considered the standard of care around the world for keratoconus and corneal ectasia following refractive surgery.
Corneal Cross-Linking FAQ
Riboflavin (vitamin B2) is important for growth, red blood cell production and assists in releasing energy from carbohydrates. Its food sources include dairy products, eggs, green leafy vegetables, lean meats, legumes, and nuts. Breads and cereals are often fortified with riboflavin.
Under the conditions used for corneal collagen cross-linking, riboflavin 5’- phosphate, vitamin B2, functions as a photoenhancer which enables the cross- linking reaction to occur.
Ultra-Violet A (UVA)
UVA is one of the three types of invisible light rays given off by the sun (together with ultra-violet B and ultra-violet C) and is the weakest of the three.
A UV light source is applied to irradiate the cornea after it has been soaked in the photoenhancing riboflavin solution. This cross-linking process stiffens the cornea by increasing the number of molecular bonds, or cross-links, in the collagen.
The Crosslinking Process
Collagen Crosslinking is a minimally invasive procedure, which takes approximately one hour, in our minor procedure room. The procedure consists of numbing the eye with drops, then removing the surface epithelial cells in the central cornea. A vitamin solution is then dripped onto the eye, followed by shining a UV light onto the eye for 30 minutes. At the end of the procedure, a contact lens will be put in place to keep the eye comfortable while the eye heals, and antibiotic and anti-inflammatory drops will be used for several weeks. Patients can expect blurry vision and mild irritation for several days after the procedure, followed by stabilization of the cornea shape and mild flattening, which in many cases can result in improved vision and contact lens fit. Contact lenses, when needed, can be re-fit after a few months. The purpose of the procedure is to prevent progression of keratoconus over time. Rarely, the procedure may need to be repeated a second time.
The Avedro system, which we offer at Vold Vision, is the only FDA approved crosslinking system in the United States. If you have been diagnosed with keratoconus or corneal ectasia, you may be a candidate for collagen crosslinking. Make an appointment with us for a full eye evaluation including corneal topography and thickness measurements. Vold Vision also offers advanced contact lens and scleral lens fitting for keratoconus, as well as corneal transplantation services, for a full spectrum of treatment for keratoconus, ectasia, and other corneal disorders.
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Care for Your Corneas
Corneas are extremely complex and they need to stay clear for clear vision. Whether you suffer an injury, infection or disease, Dr. Vold and Dr. Voicu and their team are with you every step. Vold Vision takes pride in establishing life-long relationships with patients and providing caring and customized support. We invite you to call either our Fayetteville or Bentonville practices for a cornea exam.