Diagnosis
If a corneal detachment is suspected, an anamnesis, i.e. a doctor-patient consultation, should first be conducted to identify possible causes for the damage to the cornea. Usually the characteristic very strong pain is an indication, since the cornea is very well supplied by nerves. The most important examination tool of an ophthalmologist when suspecting changes in the cornea is the slit lamp. This allows the corneal surface to be examined and assessed more closely. Depending on the cause or suspicion, staining some structures with the dye fluorescein may be helpful.
What symptoms indicate a corneal detachment?
The symptoms of corneal detachment depend on the cause and the extent of the damage. Since the cornea has many nerve endings and is therefore well supplied by nerves, an injury usually causes severe pain. Tears and detachments of parts of the cornea often cause a very unpleasant foreign body sensation.
This is due to the fact that the cornea is no longer intact and, if necessary, part of the cornea lies loose. Since the cornea is a major contributor to the ability to see, damage and detachment of the cornea can significantly impair vision. Depending on the cause, this can be differently pronounced.
In most cases there is an acute deterioration of vision, in some cases there may also be an increasing limitation. Another common symptom of a corneal detachment is reddening of the eye, which is caused by strongly filled vessels in the conjunctiva. This is also called conjunctival injection. In addition, there is often increased tearing of the eye, which is a kind of protective mechanism. It is used to flush any foreign bodies out of the eye.
Treatment and therapy
A corneal detachment can be treated differently depending on the cause. In some cases an ointment dressing may be sufficient. It has a stabilizing effect and at the same time protects against possible infections through antibiotic ointments.If there are only small tears in the cornea, they can usually heal themselves, since the corneal tissue can regenerate itself to a certain extent.
However, larger wounds require surgical treatment. In case of detachment, parts of the cornea or usually the entire cornea can be replaced. In a so-called keratoplasty, i.e. corneal transplantation, a donor cornea is used to replace the damaged cornea.
The cornea is not supplied by vessels, but by diffusion through surrounding structures, i.e. passive metabolism. This is the reason why corneal rejection is much less frequent after such a transplantation. If a corneal detachment or damage is caused by a chemical burn, the fastest possible irrigation of the eye is initially more important. If the eye is not promptly freed from all corrosive agents, permanent damage with permanent vision loss may result.
