Special Report

A Compilation of Cornea Care and Treatment

By Thomas John, MD, Guest Editor

Moore's Law states that the quantity of transistors that can be placed on an integrated circuit has doubled approximately every 2 years. Computer technology is currently moving beyond silicon chips...to DNA chips, a transition from geologic zone to biologic zone, making man-made computers even closer to man himself. When we turn from technology to medicine, and focus on the eye, and in particular the cornea, we are fascinated by the newer advances in corneal therapeutics and corneal surgery that have augmented the quality of the present day human life. To address some of these highlights, this Special Cornea Report has been compiled by leading ophthalmic experts for our audience of fellow eyecare professionals.

Corneal infection is an ocular emergency and as such, we are interested in the new developments and treatment approaches to this potentially blinding ocular infection. To address this area, Dr. Kenneth R. Kenyon from Boston describes the current clinical strategies to effectively manage bacterial keratitis. In addition to suggesting how to choose the appropriate antibiotics, Dr. Kenyon also describes the judicious use of steroids. Moving from bacterial to viral infection, every clinician will encounter herpes simplex keratitis, and Dr. C. Stephen Foster, an authority in viral corneal infections, covers the newer treatment options. Unlike corneal infection, conjunctival infections are usually not an ocular emergency, but are more commonly encountered by the eyecare practitioner. Drs. Terrence P. O'Brien and Onsiri Thanathanee provide a comprehensive look at refining the treatment of bacterial conjunctivitis and addressing the importance of MRSA infections.

Ocular surface has become an accepted region of importance with regard to both the quality of vision and the ocular comfort level of our patients. Dr. James V. Aquavella, a pioneer in various areas of dry eye treatment dating back several decades, covers important topics from dry eye syndrome to ocular allergy. Dr. John D. Sheppard describes the surgical modalities of amniotic membrane and stem cell transplantation to optimize the ocular surface that has been compromised by various disease states. These approaches add to the surgical armamentarium of the cornea specialists. Diabetic cornea can be challenging at times when the scale is tipped to the wrong side, when adverse insults compromise such corneas. Dr. David R. Hardten provides a clinically useful insight to help guide the treatment of diabetic patients with compromised corneas.

Corneal transplantation has gained significant importance from both the surgeon's and the patient's perspectives. This article provides insight as to where we are with regard to corneal transplantation and where we are headed...certainly a very promising horizon. Whenever we perform any type of ocular surgery, we are faced with both a potential infection with microorganisms, and surgically induced inflammation that can be detrimental to the patient's vision. Dr. Roger F. Steinert provides an in-depth review of the current thinking on controlling inflammation and preventing postoperative infection, both of which are of paramount importance to all ophthalmic surgeons.

In summary, this Special Report on the Cornea provides a bird's eye view of various disease entities that the practicing front-line eyecare professionals face in their day-to-day clinical practice—both in the office setting and in the operating room, and it also provides a magnified view of those important situations with regard to vision-threatening ocular conditions and the appropriate choices that one should make to safeguard the vision of our patients. We sincerely hope that this report is of value.