Eye Disorders: Coning of the Cornea, Subconjunctival Haemorrhage

Coning of the Cornea (Keratoconus)

The front of the corneas bulges forward in a cone shape. It is usually congenital and is more frequent in girls after puberty. The cornea thins near the centre and thus progressively bulges forward.

Usually the first indication is a sudden increase in astigmatism and myopia, with an axis in an oblique direction in one eye. Vision becomes blurred and cannot be corrected fully with glasses.

Given time the condition will occur on both eyes though it is more advanced on one side.

In the very early stage, spectacle glasses may help but contact lenses are more beneficial. They neutralize the irregular curve and support the cone thus arresting or slowing down the progress of the condition. Till recently only hard contact lenses could be used but now special trapezoidal soft lenses can also be utilised.

In the later stages, when scars appear in the centre of the cornea, the cornea has to be transplanted (cornea grafting or transplantation). Cornea grafts are particularly successful in this condition and have a very high rate of success if done at the appropriate time.

Subconjunctival Haemorrhage (Blood Spot)

A common condition in which a sudden red area appears below the conjunctiva over the white of the eye. It may vary from a minute spot to a wide area.

The common causes are: (a) injury leading to rupture of a small blood vessel; (b) mechanical rupture following sudden violent coughing, or vomiting especially in children. Sudden violent muscular movements like lifting a heavy weight can also cause it; (c) more rarely, a deficiency in the clotting mechanism of blood. It has also been seen to occur for no obvious reason in healthy adults.

The clot is usually bright red at first and looks more alarming than it really is. It is absorbed gradually in a week to ten days.

In the earlier stages, cold compresses are useful; later cooling drops, and a blood test, to rule out any problems, is a wise treatment.

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