Cornea
The best corneal care in the Treasure Valley area
Corneal conditions can be complex, which is why when you choose Hollingshead Barrett for your eyecare, you’ll receive treatment from one of Idaho’s only fellowship-trained cornea specialists, Dr. Ryan Barrett.
This means that in addition to cataract surgery and LASIK, Dr. Barrett has specialized training in treating all conditions of the cornea, making him one of the leading experts in the Treasure Valley area. His years of experience and expertise ensure each patient receives the best possible care using the most advanced treatment methods. Start by taking our quick Vision Quiz to learn more about your options and next steps.
How does the cornea affect my vision?
The cornea is the clear "window" that covers the iris and the pupil of the eye. For vision to be clear, the cornea must be clear. There are many different conditions that affect the cornea and interfere with your ability to see clearly. The following are a few of the most common and how they are treated.
Keratoconus
Keratoconus is a condition in which the dome-shaped cornea progressively thins and weakens. This weakening allows the cornea to change shape, often bulging and becoming cone-like, which may result in blurry or distorted vision and increased light sensitivity.
Treatment options are focused on either decreasing the risk of disease progression or on improving the quality of vision. Adequate treatment typically requires that both aspects are addressed.
Treatments to decrease disease progression include:
- Corneal crosslinking
- Cornea transplantation
Treatments to improve the quality of vision include:
- Contact lenses (soft, rigid gas permeable, or scleral lenses)
- Glasses (in very mild cases)
- Corneal Intacs (typically combined with crosslinking)
- Corneal transplantation
Fuchs’ Dystrophy
Fuchs' dystrophy is a relatively common corneal dystrophy that affects the inner surface of the cornea. These cells are responsible for pumping fluid from the cornea back into the eye. When it is unhealthy, the cells die and do not regenerate. This leaves dots on the inside of the cornea. These dots cause glare, decrease vision quality, and are often the first sign of Fuchs' dystrophy.
If Fuchs' dystrophy progresses, these cells lose their ability to pump fluid out of the cornea, and the cornea swells. When fluid accumulates, the cornea can become thicker and hazy, like a steamy window, and can cause significant vision loss.
Treatment options include medications, cornea transplantation, and other surgeries designed to replace the dysfunctional layer of the cornea with a healthy donor layer.
Dry Eye
Dry eye is a chronic disease in which people experience varying levels of eye dryness, blurriness, itchiness, and burning due to insufficient quantity or quality of tears. Whether dry eye discomfort is minor and occasional or frequent and debilitating, it can significantly affect your daily life.
More than 85% of people diagnosed with this condition have what’s known as evaporative dry eye. This is where tears lack the lipid (oil) component needed to keep them from evaporating too quickly. Based on the cause of your condition, treatment may include one or a combination of options, including eye drops, supplements, hot compresses, and certain eye procedures.
Pterygium
Pterygium is a growth of the eye’s conjunctiva (white part of the eye). This growth is made of fleshy tissue, including blood vessels, and can remain small or grow larger. Symptoms may include:
- Blurry vision
- Dry, itchy, burning eyes
- Redness and swelling of the white part of the
- Yellow spot or bump on the white part of the eye
Discomfort, redness, or swelling may be treated with lubricating or steroid eye drops. If a pterygium begins to affect your vision, surgery to remove it may be the best option.
Corneal Scarring & Other Conditions Affecting the Front of the Cornea
Corneal scarring can result from corneal injury, including abrasion, laceration, burns, or disease. Based on the degree of the scarring, vision may become blurry or be significantly reduced.
Other conditions or diseases can cause a lack of transparency in the front part of the cornea. These diseases often cause eye symptoms that can affect your ability to enjoy daily life. Such symptoms include:
- Dryness
- Pain
- Irritation
- Irregular astigmatism
Surgery may be the most appropriate treatment option for those whose vision is not improved by non-surgical methods, such as medication or lubrication.
Common Cornea Treatments
This may be needed for severe cornea issues or for patients with significant corneal scarring, edema, or clouding. Endothelial keratoplasty (EK) is a modern cornea transplant technique that replaces only the diseased layer of the cornea, leaving healthy areas intact. Further advances in cornea transplant surgery have led to the development of several different kinds of EK procedures, including Descemet's Stripping Endothelial Keratoplasty (DSEK) and Descemet's Membrane Endothelial Keratoplasty (DMEK).
These options have been shown to contribute to significantly better and faster visual recovery when compared to traditional corneal transplantation. For those with corneal scarring and abnormal blood vessel growth, Deep Anterior Lamellar Keratoplasty (DALK) and Penetrating Keratoplasty (PKP) may be the best cornea transplant procedure option.
Dr. Barrett is experienced in all types of these corneal transplants. The type of transplant he recommends for patients is based on the specific layers of their cornea that have been affected by their eye disease.
Corneal collagen crosslinking involves gently removing the surface layer of the cornea, then applying drops of riboflavin solution (a form of vitamin-B2) to the cornea, followed by a specific wavelength of UVA light. This process strengthens and stabilizes the weakened links bonding the corneal fibers together, helping preserve vision quality. While it can’t reverse the distortion of the cornea that has already happened, it locks the cornea into its current shape and helps prevent the disease from worsening.
This procedure is the first and only therapeutic treatment that has been rigorously tested and FDA-approved for keratoconus and other forms of corneal ectasia. It is a minimally invasive outpatient procedure designed to stop the progression of this disease, so it is important to be evaluated for this early in the course of the disease, before the cornea has had irreversible changes or scarring.
Hollingshead Barrett Eye Center is the only location in the Treasure Valley area to offer corneal collagen crosslinking. Because of this, we accept most insurance plans which allows us to offer our patients the most effective, affordable care.
When pterygium affects vision, surgery to carefully remove the pterygia may be recommended. This is an outpatient procedure performed under local or topical anesthesia. After surgery, the patient may return home that day and the eye is patched overnight. Healing typically takes several weeks, and patients are asked to apply prescribed topical eye-drops or ointments several times a day.
Ready to take the next step?
Schedule an appointment with one of our experienced doctors to find out how we can help you see clearly.
What our patients are saying...
Not sure if you are looking at the right service?
At Hollingshead Barrett, we are happy to help guide you through our vision correction options. Please take our vision quiz to find more information about services available to you.
*Please note that it is important to still book an eye exam with one of our doctors to ensure the right option for your specific vision is provided.