cloudy cornea

[sarah.w]

Hi guys happy easter!

quick question i woke up this morning and when i put my sclerals in i noticed that my right eyes vision was really cloudy. At first i though this was a bit of gunk on the lens but after a couple of attempts and on looking at the eye more closely i have noticed only this morning that just below my pupil covering about 1/6 of the iris is a cloudy patch. i have no pain or symptoms just cloudiness. My vision in this right eye which has not been grafted is so poor i had'nt noticed, only when putting the scleral in i noticed the cloudiness.

Any ideas on what this could be? i was thinking about having this eye grafted, do you think this is an indication the cornea has thinned a little more or ruptured?
Any ideas would be much appreciated, it hasnt come at the best time as im just doing my finals at uni! I hope it clears by morning!

Many thanks
sarah

[Andrew MacLean]

Sarah

A happy Easter to you.

Corneas are not supposed to be cloudy; in your place I'd go to your ophthalmology casualty department. I'd go today.

Andrew

[rosemary johnson]

COuld be a hydrops.
This is where the membrane at the back of the cornea splits and lets fluid from inside the eye through and the cornea gets waterlogged around the rupture.
If so, it ill heal it its own good time, and the excess water will be drained away by your body's natural junk-removal processes, which will remove the cloudiness.
If you're lucky, it will heal over well adn quickly and the scar tissue formed by the split healing will five your cornea some of the stiffening effect of a CXL treatment.
If you're really unlucky, the scarring as it heals will leave thick scar tissue that leaves a lasting smudgey bit onyour vision. If it's off-centre and the vision isn't too hot anyway, that might not be a bother even so.
Nothing can be done about it until it has healed over and the excess fluid drained away. Once that's happened, you might find a surgeon who wants to graft it. It will then be up to you to work out whether any scarring and blurred vision is bad enough to want to risk surgery.
Errr, "nothing can be done" in the sens of, they shouldn't be trying to offer you grafts till it has healed. They may suggest pain killers, but it doesn't sound like it hurts so you don't need them.
SOme practitioners like to prescribe all sorts of eye drops and goodness knows what for a hydrops. The other school of thought is to leave well alone, and go to the supermarket for your preferred painkillers if you need them. THere's also someone on here who was recommended to try blowing a hairdryer at the hydrops'ed eye to try to dry it out quicker.
On the other hand.....
it could possibly be something else - so a trip to A&E would be a sensible plan.
Good luck, and do let us know what happens.
Rosemary

[sarah.w]

Thanks for the advice guys
I had the eye check and apparently the eye is fine its just scarring which i have had for a while. They told me that the right eye has already had hydrops, however to be honest with you i have never had any pain or symptoms of hydrops so im not sure. After speaking to a few clinicians it appears the new surgical procedures used is DLK. I previously had a full thickness graft on my left eye in 2003. I have not heard of DLK so does anyone have any experience of this?

I am going back to see my optom just incase its not friction between the lens and the cornea but i am also going to see (fingers crossed) my old surgeon for his opinion.

thanks
sarah

[GarethB]

Deem Anterior Lamellae Keratoplasty (DALK) is basically a pratial thickness graft, the top two layers of the cornea are removed and you keep the inner most layer. If scarring is deep a full Penetrating Keratoplasty (PK) graft which you have already had on your left eye will be done.

Quite a few people on the forum have had the DALK so you should get quite a few replies, some I think have kept a blog of their recovery.

Regards

Gareth

[rosemary johnson]

If your eye has had a hydrops, it is very unlikely they will be able to do a DALK (partially thickness) graft, becasue the scarring left by a hydrops is generally in the layer that would be left behind by a DALK.
It is possible to have a little hydrops and not realise - it was only by hindsight I started to wonder, about my third one, whether that had actually been a mini-hydrops and I hadn't realised at the time...... I went in to the hospital next orutine appointment, said I was wondering this.
"SHouldn't think so," I was told. "It's normally impossible to have hydrops twice inthe same eye." THen he looked at the eye down the slit lamp and said "Do you know, I think you're right."
If I hadn't already had two, much bigger, ones, it would never have occurred to me.
Hydrops don't always give a lot of pain - some people find them horribly painful, others not. And that's not always linked to size/severity.
You mght have had a brief period where the eye was a bit more uncomfortable, and not realised it was a hydrops. If you hadn't had several of them before and th eworld wasn't a complete white out, why should you?
Rosemary

[sarah.w]

Thanks guys i have searched through the forum and learnt quite a bit about the DALK procedure! I watched a video of one too which my optom recommended so i could see how it differed from my PK which was on my left eye. When i eventually do go to have surgery i presume its up to the suregons disgression and the extent of the scarring as to what they decide;a DALK or PK?

Do you think there would be any advantages vision wise to me having the DALK post surgery or is it similar to post PK? To be able to wear a pair of glasses just for the half hour in the morning before putting my sclerals in would make such a massive difference to my life, but as with everything you can never tell whats going to happen when the stiches are taken out!

Any experiences would be greatly appreciated

Thanks again

[rosemary johnson]

If you've had a hydrops, it's unlikley they'll do a DALK on that eye as the vcarred area will be left in the layer the DALK leaves behind, thus affecting your post-graft vision.
IN general, a DALK graft is less likely to reject, but can take more time to heal over fully (because the layers have to mesh).
A PK heals quicker and maybe more regularly because there is just one deam to heal, but is at slightly greater risk of rejection because it is all foregin tissue, without the back layer of your own tissye remaining.
Vision varies from person to person, eye to eye.
Rosemary