MR E MARK TALBOT

INFORMATION SHEET

BULLOUS KERATOPATHY / corneal decompensation.

This is water logging of the cornea. The cornea normally keeps itself cleared by pumping fluid that has accumulated in the cornea out of the cornea. The cells that are responsible for this are layered on the back surface of the cornea. To keep the cornea clear a critical number of functioning pump cells are required. Many people have enough cells to last them 120 years. Some people are born with less cells or have a faster loss of cells. Once the number of cells falls below a critical level the total pumping effect is inadequate causing excess fluid to collect in the cornea. Once this corneal decompensation occurs the cornea becomes cloudy and starts to scatter light instead of focus it.

Loss of cells occurs: naturally with age, following any severe blunt injury, following penetrating injury such as stab wound or surgery, and following intraocular inflammation. Once the number of cells reduces to below a critical level the cornea starts to accumulate water and this can result in loss of transparency. As the eye condition progresses the fluid can cause surface epithelial blisters. If these rupture it causes pain because of exposed corneal nerves. This loss of epithelium (surface skin of the cornea) can predispose to serious corneal infections.

Your Ophthalmologist will decide how best to treat it depending on the vision before the cornea decompensated, how it responds to eye drops, control of pain. Sometimes a bandage contact lens is used to achieve comfort provided that the eye is not dry and occasionally CORNEAL GRAFT SURGERY is performed to relieve pain or to restore transparency for vision.

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