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Corneal Opacity

(Corneal Opacification; Cloudy Cornea)

Definition

Corneal opacity is a disorder of the cornea. The cornea is the transparent structure on the front of the eyeball. Corneal opacity is when the cornea becomes scarred. This reduces the light passing through the cornea to the retina and may cause the cornea to appear white or clouded over.

Causes

Infection, injury, or swelling of the eye are the most common causes of corneal opacity.

Risk Factors

Factors that may increase your chance of corneal opacity:

  • Foreign bodies striking the eye
  • Eye injury, whether from a force, such as a poke in the eye, or from a chemical agent
  • Wearing contact lenses for a long period of time, especially overnight, can increase the risk of eye infections and also the chance of developing corneal opacity.
  • Herpes simplex virus —which can be transmitted to the eyes
  • Measles —when measles results in scarring/infection of the eye
  • Other infections, including conjunctivitis
  • Vitamin A deficiency
  • Keratoconus
  • Stevens-Johnson syndrome
  • Congenital corneal abnormalities

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Symptoms

Corneal opacity may cause:

  • Vision decrease or loss
  • Pain in the eye or feeling like there is something in your eye
  • Eye redness, excessive tearing, or light sensitivity
  • Area on the eye that appears cloudy, milky, or is not completely transparent

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

To prepare for a complete eye exam, your doctor may put drops in your eyes to numb them and to dilate your pupils. A specialized microscope will be used to focus a high-powered beam of light into your eye to examine the cornea and other structures in your eye.

Treatment

Talk with your doctor about the best treatment plan for you. Treatments vary depending on the most likely cause of the scarring and how severe the scarring is. Treatments may include:

  • Eye drops containing antibiotics, steroids, or both
  • Oral medications

In some cases, scar tissue may be removed surgically. The surgery may be performed using a laser, called phototherapeutic keratectomy (PTK), if the scarring is close to the corneal surface. In more severe cases, a cornea transplant (keratoplasty) may be necessary.

Prevention

To help reduce your chance of corneal opacity:

  • Take care to avoid injuring the eye. Wear eye protection during any potentially dangerous activity. Make sure safety goggles are worn tight against the face, otherwise a foreign body can fly up under the goggles and injure the eye.
  • Take proper care of contact lenses. Follow your doctor’s recommendations regarding wear and cleaning them.
  • Keep your eyes from drying out by using saline eye drops.
  • See your doctor right away if you think you have an eye infection, if you injured your eye, or if you develop any pain or change in vision.
RESOURCES:

American Optometric Association
http://www.aoa.org

Eye Health—American Academy of Ophthalmology
http://www.eyesmart.org

CANADIAN RESOURCES:

Canadian Ophthalmological Society
http://www.cos-sco.ca

Health Canada
https://www.canada.ca

REFERENCES:

Congenital Corneal Opacities. American Academy of Ophthalmology. Available at: https://www.aao.org/topic-detail/congenital-corneal-opacities-europe. Updated November 2015. Accessed December 14, 2017.

Facts about the cornea and corneal disease. National Eye Institute website. Available at: https://nei.nih.gov/health/cornealdisease. Updated May 2013. Accessed December 14, 2017.

Rangel TR. Sectoral keratitis and uveitis. Ocular Immunology and Uveitis Foundation website. Available at: http://www.uveitis.org/docs/dm/sectoral_keratitis.pdf. Accessed December 14, 2017.

Williams K, Irani Y, Klebe S. Novel therapeutic approaches for corneal disease. Discov Med. 2013 May;15(84):291-9. Available at: http://www.discoverymedicine.com/Keryn-A-Williams/2013/05/24/novel-therapeutic-approaches-for-corneal-disease/.. Accessed January 3, 2018.

Last reviewed November 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP  Last Updated: 12/20/2014