CORNEAL OPACITY

• ‘Corneal opacification’ literally means loss of normal transparency of cornea, which can occur in many conditions. Therefore, the term Corneal opacity' is used particularly for the loss of transparency of cornea due to scarring
• A corneal opacity or scar will prevent the light and the image from being properly transmitted to the retina. Images can become distorted, leading to decreased vision
• Corneal diseases represent the second leading cause of blindness in most developing world countries. Nearly 80% of all corneal blindness is avoidable

Types

• Nebula – Faint opacity, Involves Bowman’s layer and superficial stroma
• Macula- Semi dense opacity, ½ of Corneal stroma involved
• Leucoma- Dense white, More than ½ of stroma involved

• Corneal opacities are caused by anything that can lead to a scar. Most common causes are eye injuries and infections
• Congenital opacities may occur as developmental anomalies or following birth trauma
• Healed corneal wounds
• Healed corneal ulcers

Generally, patient presents with

• The area on the eye that appears cloudy, milky, or is not completely transparent
• Blurred Vision, double vision
• Excessive tearing, light sensitivity (photophobia)
• Pain in the eye or foreign body sensation presenting with a history of infection or injury points to corneal damage

Corneal opacity may produce a loss of vision (when dense opacity covers the pupillary area) or blurred vision 

Depending on the cause, symptoms of corneal damage may include:

• Redness and swelling of the eye tissues and eyelid
• Tearing
• Blurred vision
• Irritation
• Sensitivity to light
• Sensation of something in the eye
• Eye discharge
• Milky or cloudy area on the cornea
• Vision loss

• Ocular examination - Diffuse light examination for gross lesions of lids, conjunctiva and cornea including testing for sensations
• Vision Assessment - Refraction
• Slit-lamp examination – To assess Corneal Oedema, Vascularisation, Epithelial Defect etc
• Tear film evaluation –Tear production- Basal Schirmer test < 5mm – dry eye, tear film break up time - < 10-sec unstable tear film

• Optical iridectomy
• Phototherapeutic keratectomy (PTK) performed with the excimer laser is useful in superficial (nebular) corneal opacities
• Keratoplasty provides good visual results in uncomplicated cases with corneal opacities
• Cosmetic coloured contact lens- gives very good cosmetic appearance in an eye with an ugly scar having no potential for vision
• Tattooing of scar

Ayurvedic Treatment

• Treat according to the cause

Internal medicines

• Triphala gritha
• Thikthaka gritha
• Patoladi ghritha

Procedures

For Nebula and macula type ( pain less condition)

• Netradhara - Darvi+ Yasti+ Lodra kashaya
• Jaloukavacharana – on forehead
• Virechana - Avipathi Choorna
• Nasya - Ksheerabala avarthi
• Anjana -Jateemukuladi varti+ honey , Elaneerkuzhambu, Mudganjana
• Lekhana Anjana
• Netra Gharshana - Triphala bhavitha Saindava ( Under expert supervision)
• Putapaka – Lekhana putapaka