cloudy cornea:take 2

[sarah.w]

hi guys

I don’t know if you remember but back in easter my unoperated right eye went cloudy for a few days but it did clear after a couple of days thankfully. I went to see a surgeon at bristol eye hospital who said the scar looks deep enough to need a full thickness graft but it was ultimately up to me to decide as he thought the vision behind the scar was pretty good. I decided to hold off my surgery until absolutely necessary as i have just finished my degree and wanted to get on with finding my first physio job!
However on sunday eve i noticed the cornea had become cloudy again and this time it was worse than before, It is now Thursday and the eye is no different. I have left the lens out since Sunday to rest the eye but it doesn’t seem to be resolving at all. Im a little worried now as i know i would not be able to work with my eye like this as it throws me completely, i am due to see the surgeon next month for a follow up to see what he thinks.
If any of you guys have experienced this or similar or have any ideas on what you think i should do it would be much appreciated

many thanks
sarah

[Lizb]

I dont think that i would wait until next month if my vision detoriated like that. the minimum i would do is go along to an opticians (the understands KC) for a quick check up if you cant get to a decent Eye A&E.
I have done that numerous times recently but with bloodshot eyes and lower vision that normal, i dont even need to tell the receptionist my name now they all know me. I am lucky that because my hospital outsources CL fitting to a local opticians i go and see these for my general check ups as well and they know and understand KC.

[Anne Klepacz]

Sarah - I'm with Lizb. Do go to A&E. Sounds as though you may have another hydrops, but someone really needs to look at your eye. All the best.
Anne

[sarah.w]

hey thanks guys im booked in for an appointment at plymouth eye a+e tomorrow, i dont know too much about hydrops does this sound like hydrops? its just very cloudy and there is no redness/discharge and it isnt painful.
thanks
sarah

[GarethB]

Hydrops is basically where the endothelium ruptures (inner most layer of the cornea) and fluid from the eye between the cornea and lens enters the Stroma (middle layer of the cornea). It is this fluid entering the cornea that makes things cloudy.

The other time the cornea goes cloudy is when the cornea becomes scared, in our case this can be due to contact lenses rubbing on the cornea.

In both cases they can be accompanied by pain and/or redness of the eye but not always.

I think in both cases you are advised to go without lenses and are prescribed antibiotic eye drops to make sure nothing becomes infected and to aid the healing process.

There can be good news if you have hydrops and there have been many cases where the small amount of scar tissue left has resuslted in the KC effectively regressing. By this I mean an improvement in unaided vision has been reported and confirmed through eye tests and lens fitting has become easier.

I think there was period in the 1950's where one of the treaments for KC was to carully induce hydrops so the scaring would help strengthen the cornea and improve vision.

[sarah.w]

Hi guys
I went to the eye a+e this morning and they confirmed staright away that it was hydrops. This is my 2nd episode of hydrops now and they have said for me to keep my scleral lens out of the eye for a couple of mornths as it is quite swollen/inflammed. I must admit i didnt realise that hydrops could take that long to settle!
I have just finished uni and at the moment i feel so thrown with the extremes of vision in my left and right eye that i would'nt feel happy applying for any physio jobs just yet . Does any one have any experience of hydrops and rough healing times? I am due to see a specialist in plymouth as soon as i am referred and i also have a topography scan in bristol in late sept.

I know having a graft on the right eye is a massive step but at the same time even if the hydrops resolves and im left with the same if not worse hazy vision lenses cannot correct this anyway.

sorry for the rambling!
sarah

[GarethB]

Until the hydrops has healed there is no way of knowing if you will have any scaring or hazyness left.

Intacs may still be an option and take the steepness out fo the cornea and thus potentially reduce the risk of hydrops and making the cornea a more regular surface onto which a lens an be fitted. CXL may still be an option.

From what I have read on the forum, the time it takes for hydrops to heal is like asking how long is a piece of string, it is a very individual thing.

I think is probably pointless thinking about grafts until the hydrops has healed and should only be a last resort as the other medical interventions still mean a graft is an option if necessary. Going for a graft rules out many options straight away.

[sarah.w]

thanks gareth,
is CXL - collagen cross linking? also what is intacts as i have heard of it but im not quite sure what it is! I think they were thinking of a graft as i have such severe KC in my right eye and the astigmatism is very high

thanks for your help

[Andrew MacLean]

Sarah

If you have very severe KC it is likely that your cornea is already too thin for either CXL or INTACS.

The INTACS procedure is like ferrarrah rings; they insert little arc shaped pieces of plastic into the cornea so that the leading edge is flattened. The aim is to give better vision, but to be contemplated your cornea has to be thick enough to receive the little half rings.

An odd thing about Hydrops is that they can leave you with better vision; I think that the scar that forms inside your eye has the effect of tightening the cornea. On the other hand; if the scar is in the wrong place it can leave you in need of a graft.

All the best

Andrew

[rosemary johnson]

Hi - and much fellow-feeling from somene's who survived 4 hydrops!
Healing can vary, as the hydrops themselves can vary in sizze. And hence effect.
My first two, the world went completely white - like a steamed up bathroom window - for a month. They cleared between a mont and six weeks after the obset (cleared gradually, I mean.
In all cases, even once the white fog had cleared, the eye in question was more sensitive and the lens wearng time not so reliably good for some time - a few months, I mean.
My Nos. 3 and 4 were much more minor - little bits of white mist itnhe centre only, and I had a lens back in within a week (of necessait I hasten to add, as the other eye was too sore to try to get a lens in.
About of pain, redness and resulting scarring also vary immensely. My first left almost no scarring,and the others a bit more, but not enough to have a graft becoe "necvessary".
It is possible the scarrng from a hydrops with thicken and strengthen the cornea - and that the scrring will heal over enough to have no noticeable effect on your vision. In which case, they are "inificial" in some ways.
Treatment options vary - som people, including my consultnts/CL peple, reckon the best thing to do with a hydrops is to leave it well alone to heal itself and after 4, I'd go along with that. I think I was prescribed painkiller eye oointment, but frankly you get painkillrs more cheaply inthe supermarket called ibuprogen or paracetamo l or aspirin....
SOme other medics like to prescribe this drop and that drop and the other drop, and saline which stings and antibiotics "just in case".
THey doubtless ahve their reasons, but p
personally, I'll stick to leaving well alone.
There's nothing they can do till it has healed over and the fogging cleared away (it is caused by the fluids that escape into parts of the eye where they shouldn't be and you just have to wait till your mtabolism naturally clears the stuff aay.
Except, that someone on here was told to try a hairdryer. Pointing at the eye withthe ydrops. It's supposed to help it dry out more quickly.
SOme clinics seem tothink "hydrops" = "need a graft quickly". Others reckon it is never a good idea to do a graft on an ee that has recently had a hdrops, and it is better to give it plenty of time toheal and de-fog and generally settle down.
Hope yours clears up quickly. Do ask any ore if you have more questions.
Rosemary