Swelling of the cornea

I have been trying to find some information about corneal swelling, but I cannot seem to find much useful information. I thought I would post here about this experience, and see if anyone could help me out. I also hope that this will in some way help someone else.

I took my boys to the eye doctor a few days ago for an eye exam (my daughter will get her eyes examined soon, I did not forget her). My younger son wears glasses, and had been complaining his glasses were not strong enough. Just for good measure, I also had my older son get an exam, even though he does not have any problems with his vision. The eye doctor said his vision is better than 20/20. The problem is, the cornea in his right eye is swollen (he said it is the Stroma, the middle part of the cornea that is swollen). I was quite surprised. His eye does not bother him at all. He has not been rubbing it or anything. Shocked

The eye doctor asked if he has any skin conditions. I told him he had some eczema when he was a baby, but that was all, and he has not had any problem with that since he was a toddler. I thought maybe he out grew it or something. The doctor then explained to me that you never out grow eczema. I did not know this. Their pediatrician never explained that to me. (I feel kinda stupid, but at this point it doesn't matter) The eye doctor told me he believed the swelling of my sons cornea was because of the eczema.

I asked him what we are going to do about the problem. He said he was prescribing 2 eye drops. One for any itching, because he absolutely cannot rub his eye (he said no one should ever rub their eyes, as it can cause permanent damage), and another one that will hopefully make the swelling go away. He also said I have to bring him back in 30 days so he can check it.

Now, I did ask questions about this while I was there, and I received answers. Then after I got home and had some quiet time, I began to think more about this and ended up having a lot more questions.(I think that happens to everyone. I do not think anyone can possibly think of every question they have right then and there, especially when it is something unexpected that you never saw coming) I was really taken by surprise when he told me my sons cornea was swollen. I would not even had known there was any problem at all if I had not had his eyes examined.

The questions I have, are: Can corneal swelling cause permanent damage? What if the swelling does not go away with the eye drops? What is the next step?
I was taken by such surprise by this. I had no idea eczema could even affect the eyes like that. I want to make sure I do the right things, and ask the right questions when I take him back. Vision is so important. He will be 13 soon, and has a long life ahead of him and I want to do everything I can to make sure he has healthy eyes. What other kinds of questions should I ask? Puzzled

Puzzle, I have no idea what

Puzzle,
I have no idea what to tell you about your son's condition.

I just wanted to thank you for mentioning that eczema is permanent and can affect the eyes. I have had eczema and I have never been told this by any doctor, and several have treated it.

You are right puzzle. There

You are right puzzle. There is not a lot of information out there in regards to corneal swelling and eczema. I must admit I only spent a few minutes looking out of curiosity.

Hopefully someone will be able to help you out with your questions.

I did not know we were not supposed to rub our eyes. Every ten years or so I will get really bad allergies. My eyes itch so much I want to take them out of my head and scratch them. It is very frustrating.

Well, I'm glad my post has

Well, I'm glad my post has given both of you some useful information. It's amazing how much you can learn during an appointment that lasts only a few minutes. I'm hoping I can find some sort of information, or that someone will come along who knows something about it, or about the eyes in general. I kept trying to change how I worded my search, hoping it would bring up some type of information. I googled "swelling of the stroma" and almost fell out of my chair, cause it didn't bring up anything about the swelling of the corneal stroma (not by itself, or in children, or with eczema), but it did bring up articles and information on "Swelling studies of camel and bovine corneal stroma" I suppose the next time my camel is having eye problems, I'll know which words to google! Laughing out loud

I did not know you were not supposed to rub your eyes, either. To me, it's just always been a natural reaction to rub them when they're itching. Perhaps you could talk to your eye doctor about it, and get some prescription eye drops for the itching when that happens. (I know that cold helps stop itching. I bet a bag of frozen peas would feel pretty darn good on your eyes if they're itching like that!)

I know I am going to ask the doctor the following questions when I return with my son for his check up...

1. Is this something that can occur again?
2. How often should I bring him to have that checked?
3. Can the swelling of his cornea cause permanent damage?
4. Is there any way to prevent his cornea(s) from swelling again?
5. How common is this sort of thing?
6. Do you have any written literature, or information I can have to read about this?

If anyone has any ideas of other questions I could, or should ask, please feel free to share them with me. You guys know I love to learn and I'm always open for advice.

I found the following

I found the following information. I am not sure if it applies to your situation, but found it interesting.

Atopic Keratoconjunctivitis

Atopic keratoconjunctivitis is one of the most severe forms of eye allergies. People with eczema are more prone to it. Continuous itching and dry eyes are the common symptoms, which is followed by blurred vision. Atopic keratoconjunctivitis, also referred as eczema eyes, if not treated can lead to corneal swelling and conjunctival scarring. This form of eye allergy is quite rare and is seen mainly in older people.

Apart from airborne allergens, atopic keratoconjunctivitis can be caused by common food substances. Topical antihistamines, mast cell stabilizers and short term use of steroids are the ideal treatment.

http://www.childrensdisabilities.info/allergies/eyesallergies.html

You may wish to try the

You may wish to try the search terms stromal edema or corneal edema.

Here is some information I found that may or may not be helpful.

Corneal Edema

Corneal edema, one of the two types of ocular edema, is characterized by swelling and/or inflammation of the cornea. This eye condition may result from infection, ocular diseases, postoperative complication or prolonged use of contact lenses.

Cornea is a clear, transparent, dome-shaped structure that covers the front portion of the eye. An adult cornea is about 0.5 millimeters thick. It comprises five major layers, namely, epithelium (outer portion, having the ability to regenerate), Bowman's membrane (hard, protective layer), stroma (thickest layer with collagen fibrils), Descemet's membrane (thin layer) and endothelium (one-celled thick innermost layer). Since there are numerous nerve endings in the cornea, it is extremely sensitive. On the contrary, cornea is devoid of blood vessels and hence appears transparent.

Cornea functions as a powerful refracting medium, contributing the maximum focusing power to the eyes. Cornea is kept transparent for the maximum vision clarity by supplying oxygen from the tears and pumping of water from the endothelium layer. When there is excess hydration or accumulation of fluid in the cornea portion, then it causes corneal swelling; a common eye problem referred to as corneal edema.

Corneal Edema: Causes and Symptoms

Corneal edema is caused by the problems related to dehydration, viral infections, endothelial disorder, ocular surgery, traumatic injury, increased ocular pressure and at times, toxins. Among these, endothelial Fuch's dystrophy is the most common cause of corneal edema. It is a hereditary disorder, characterized by slow and gradual loss of endothelial cells. Women are at a higher risk of endothelial dystrophy than men.

An infection by herpes viruses results in inflammatory responses in the cornea, leading to corneal edema. Corneal edema may also occur immediately or few years after the ocular surgery. It may occur due to impairment of endothelial layer by ultrasound radiation, damage of Descemet's membrane and/or infusion of toxic medications in the cornea. In addition, strong topical and systemic medications can lead to corneal edema.

The most notable early symptoms of corneal edema are distorted or blurred vision, halos around light, eye discomfort, photophobia (increased sensitivity to light) and sensitivity to foreign particles. Symptoms may progress to severe pain in the eye due to the corneal nerve damage. Pseudophakic bullous keratopathy (PBK) that results in the formation of fluid-filled bullae or blisters is commonly observed after the cataract surgery.

Corneal Edema: Diagnosis and Treatment

As early symptoms of corneal edema are similar to cataracts, it is necessary to undergo ocular evaluation for the correct diagnosis of corneal edema. The eye care specialist may conduct specular microscopy, ultrasound and optical pachymetry (measurement of corneal thickness) in order to confirm the diagnosis.

The treatment of corneal edema varies based on the exact cause of the condition. In case of condition caused by ill-fitting or over wear of contact lenses, the use of correct contact lenses is recommended. Similarly, corneal edema caused by increased eye pressure is treated by lowering the pressure. Corneal edema developed as a post-surgery complication can be improved by administering eye drops prescribed by the eye care practitioner. The doctor may prescribe antibiotics and anti-inflammatory eye drops for the infection related corneal edema.

In case, corneal swelling is restricted to the epithelial layer, it can be treated by using common salt solution. Over here, salt solution extracts the excess fluid accumulation in the cornea by osmosis. In severe cases, corneal transplant may be recommended as a treatment option. Proper eye care and eye exercise should be practiced to relieve the symptoms of corneal swelling.

If corneal edema is left untreated for a prolonged duration, then the symptoms may worsen to chronic eye conditions such as stromal edema and intercellular epithelial edema. Hence, in order to avoid such complications, it is always recommended to seek advice from a qualified eye specialist for early diagnosis and correct treatment of corneal edema.

************************************

Some questions I would ask are if this could be caused by an infection or allergy and if this is something that will require more frequent screening by an eye doctor.

Hope this helps

Kat, why am i seeing a pink

Kat, why am i seeing a pink background on Ink's post? I thought only moderators saw pink after a post was removed from view on the forum?

gagal wrote: Kat, why am i

gagal wrote:

Kat, why am i seeing a pink background on Ink's post? I thought only moderators saw pink after a post was removed from view on the forum?

I'm seeing pink, too. I guess it's better than seeing red. Eye-wink Sticking out tongue

abusedemotionally

abusedemotionally wrote:
gagal wrote:

Kat, why am i seeing a pink background on Ink's post? I thought only moderators saw pink after a post was removed from view on the forum?

I'm seeing pink, too. I guess it's better than seeing red. Eye-wink Sticking out tongue

LOL

Do you see naked men dancing, cause I see that too?

gagal

gagal wrote:
abusedemotionally wrote:
gagal wrote:

Kat, why am i seeing a pink background on Ink's post? I thought only moderators saw pink after a post was removed from view on the forum?

I'm seeing pink, too. I guess it's better than seeing red. Eye-wink Sticking out tongue

LOL

Do you see naked men dancing, cause I see that too?

No, Stare . . . can't say that I do . . . Innocent

What I am seeing are one-eyed basset hounds, with an egg in one paw and a paint-sprayer in the other. Shock Puzzled

Go figure, huh?? Sticking out tongue Evil

abusedemotionally

abusedemotionally wrote:
gagal wrote:
abusedemotionally wrote:
gagal wrote:

Kat, why am i seeing a pink background on Ink's post? I thought only moderators saw pink after a post was removed from view on the forum?

I'm seeing pink, too. I guess it's better than seeing red. Eye-wink Sticking out tongue

LOL

Do you see naked men dancing, cause I see that too?

No, Stare . . . can't say that I do . . . Innocent

What I am seeing are one-eyed basset hounds, with an egg in one paw and a paint-sprayer in the other. Shock Puzzled

Go figure, huh?? Sticking out tongue Evil

Oh, yeah, I don't see naked men dancing either. It must have been my imagination. Puzzled

Maybe you should call animal control if there is a one-eyed basset hound on the loose. It might get hurt, especially since it seems to be armed. Smiling

Sorry, Puzzle. It's AE's fault. Let us know how your next doctor appointment goes. I am curious about what answers you get to your questions.

Okay...I wanted to come and

Okay...I wanted to come and talk to you guys about what has happened. There has been an interesting, yet disturbing twist of events.
As you all know, I was quite confused about my sons cornea. I mean, he had absolutely no symptoms. His eye was not red, itchy, hurting, watering, absolutely no symptoms at all. I finally got a chance to talk to his pediatrician. When I told her about the appointment at the eye doctor, she was not happy at all.

She said first of all, that particular eye doctor is just an optometrist. She said the cornea is out of his scope of practice, and he never should have taken it upon himself to try to treat his eye. She said if he thought my sons cornea was swollen, then he should have referred him to see an opthalmologist (however you spell that word! You guys know what I mean) She told me he is always over diagnosing children, and taking it upon himself to do things that are out of his scope of practice. She then told me, that she has another patient who he did something similar to. The child was prescribed eye drops for their eye, and as time went on, the eye was getting worse and worse. The child was then sent to a specialist, and it was discovered that the child never even had a problem with that eye in the first place, and it was the eye drops that were given to the child that were causing the problems with the child's eye. She said the parents almost sued that eye doctor.

I am disturbed by this for a few reasons. For not taking him for another opinion right away, and instead putting the drops in my sons eye without question. For not knowing that was out of his scope of practice, and to question him about treating my sons eye.

His pediatrician told me to stop putting the eye drops in his eye immediately, and she gave a referral and even made an appointment for me to take him to see an opthalmologist (spelling, again, sorry). I am now trying to decide if I should cancel my sons follow up appointment with the optometrist, or if I should keep the appointment simply so I can ask him why he did not refer my son to a specialist if he thought my sons cornea was swollen, and try to get some answers.
So that is where we are now. I hope someone can learn something from my experience. I know I am learning lots of stuff. I'll let you guys know what happens when I take him to the specialist.

As the eye doctor is out of

As the eye doctor is out of his range of skill, why go back? I doubt any answers would be forthcoming.

Best of luck to your son.

Hi Puzzle, What drops were

Hi Puzzle,

What drops were you given? Were you given steroids?

I have had countless negative experiences with ophthalmologists (which I will refer to as eye docs, easier to spell). Don't pin all your hopes on the eye doc most of them are only interested in doing surgeries like Lasik they don't care about eye disease. I would not destroy your relationship with the optometrist, you may need to go back to him if the eye doc doesn't help you. I have at times found optometrists much more helpful than eye docs because they at least take the time to explain things to you, unlike the eye docs who rush you out the door.

The sad fact as I said is that 99% of eye docs want to do surgeries that make them losts of money. They loathe dealing with eye diseases like yours as they tend to be chronic and time consuming. Be prepared to have to be very assertive with the eye doc as they are likely to try to get rid of you.

I believe that people with eczema are also more likely to get blepharitis and dry eye. You might want to read up on this as he'll need to maintain good eyelid hygiene etc to hopefully prevent problems.

Thanks guys...I'm going to

Thanks guys...I'm going to take him to the specialist, and see what they say. Thank you for your warning, Poppy. The eye drops that were prescribed were Lotemax. I looked it up and it is a corticosteroid. I'm not sure what could happen if it is used and there is no problem and it is not needed.

There is a different optometrist I will take them to from now on. I have seen him before, and I think that will be better. I've been a bit confused about all of this, but hopefully everything will work out well.
The specialist is associated with a children's hospital, so I'm hoping there will be no problems, like them trying to get rid of us.

Anyway, my son is doing well. He's been participating with the football team, and is having a great time. My kids start school on Monday...Yay!!!

Okay...I took my son to the

Okay...I took my son to the specialist. The Dr. said he has a scar on his cornea, and his cornea is also a bit cloudy. He said the scar could be from years ago, or it could be from something recent, he isn't sure. I do not remember my son ever having any type of eye injury. He said for now, we are not going to treat it. He wants to see him back at the end of September, so we can see if the cloudiness has cleared up any, or if it's getting worse or what. Then we will go from there. He also said he thinks my son has a bit of blurry vision in that eye. It's not enough for my son to notice, but the Dr. said that when the cornea is cloudy, that it causes blurry vision. They did do an eye exam, and he did have a wee bit of trouble seeing a few of the letters with that eye, although he insists he has no problem seeing a thing.

Anyway, I wanted to let you guys know what happened. I'm glad I took him there. I'll let you guys know what else happens.

Thanks for the update.

Thanks for the update. Hopefully, the issue will resolve itself and your son's vision will be ok.

Puzzle wrote: Okay...I took

Puzzle wrote:

Okay...I took my son to the specialist. The Dr. said he has a scar on his cornea, and his cornea is also a bit cloudy. He said the scar could be from years ago, or it could be from something recent, he isn't sure. I do not remember my son ever having any type of eye injury. He said for now, we are not going to treat it. He wants to see him back at the end of September, so we can see if the cloudiness has cleared up any, or if it's getting worse or what. Then we will go from there. He also said he thinks my son has a bit of blurry vision in that eye. It's not enough for my son to notice, but the Dr. said that when the cornea is cloudy, that it causes blurry vision. They did do an eye exam, and he did have a wee bit of trouble seeing a few of the letters with that eye, although he insists he has no problem seeing a thing.

Anyway, I wanted to let you guys know what happened. I'm glad I took him there. I'll let you guys know what else happens.

As a family doctor, I never prescribe steroid eye drops.

As a family practice resident it was drilled into us to never prescribed this type of medication, and this class was only to be given by Opthalmology. There are a number of serious side effects that this medication has the potential to cause, as your pediatrician mentioned.

I don't understand the rationale for prescribing steroid eye drops when your son had NO eye symptoms. I suggest that you ask the Optho at your next appointment why this optometrist would do such a thing; I would be interested in hearing the answer.

chrisaldridge wrote: As a

chrisaldridge wrote:

As a family doctor, I never prescribe steroid eye drops.

As a family practice resident it was drilled into us to never prescribed this type of medication, and this class was only to be given by Opthalmology. There are a number of serious side effects that this medication has the potential to cause, as your pediatrician mentioned.

I don't understand the rationale for prescribing steroid eye drops when your son had NO eye symptoms. I suggest that you ask the Optho at your next appointment why this optometrist would do such a thing; I would be interested in hearing the answer.

As a patient I really wish GPs were NOT taught "NEVER prescribe steroids".

As a patient with chronic inflammation of the eyes, not being able to get a repeat prescription from a GP for something I am basically dependent on is a major issue.

Eye docs hate patients with chronic diseases (as I've previously mentioned, they just want to do surgeries), so getting regular appointments and care from an eye doc is very hard. It would be much easier and cheaper for the patient to be able to get steroid drops from a GP. Yes long term use of steroids causes issues but so does chronic untreated inflammation of the eye. Not to mention, that chronic keratitis as I have is a very difficult thing to live with. When I see an eye doc all they ever do is give me steroid drops. If I could get these drops from a GP, then I wouldn't have to take time off work (lost income) to see the specialist as well as pay a fortune to the specialist in fees.

Chris, I don't understand it

Chris, I don't understand it either. I was clearly surprised when the optometrist said his cornea was swollen, and I asked him why my son had no symptoms, and he really had no answer. I will ask the Optho why the optometrist would do such a thing. When the Optho asked about who the optometrist was, it seemed by his expression that he knew of him, although he really did not say anything. I've considered talking to the optometrist, and asking him directly why he would do such a thing without referring him in the first place. (I can't help but wonder if the cloudiness of his cornea could be from the drops) This has certainly been a learning experience. I will let everyone know when I find anything out.

Poppy, I'm sorry to hear of the trouble you've had, both with your eyes and with your doctor(s).

There are a number of

There are a number of excellent reasons why family MDs don't script steroid drops.

Steroid drops have the potential to cause:

1. Cataracts.
2. Glaucoma.
3. Corneal Ulcer.

An Optho has specialized equipment (such as a slit lamp) and knowledge for examining the eye. A family MD does not.

While you may have to take time off work, the alternative (i.e. missing something important) I would think would be a lot less
preferable.

Well, I took my son to the

Well, I took my son to the optometrist yesterday. I decided to do this so I could ask him directly about why he did that, and what happened. I told him about my sons pediatrician telling me to STOP the eye drops immediately, and sending him to the specialist. I told him that she said he should have sent my son there is he suspected a problem with his cornea, instead of giving him the eye drops.

I could see the surprise, and irritation in his expression. He then said he did not understand why the pediatrician was so upset about the eye drops. He then tried to give me a bunch of reasons for what he did, including telling me that steroid drops are the standard of care when there is swelling of the cornea, and he said there is nothing wrong with using them when it is appropriate. Then he said he wanted to call the pediatrician. So I gave him her card and said okay. I know she will chew him out. He will not probably expect the way I'm sure she will go off on him. Perhaps he will listen to her, cause he sure didn't want to listen to me.

He asked me what the specialist said. I told him the specialist said he has a scar on his cornea, and that his cornea was a bit cloudy, and it was not swollen. The optometrist proceeded to ask me repeatedly: "So the specialist agreed that there IS a problem then?" I said yes, he said there is a problem, and he said there is a scar on my sons cornea, and it was a bit cloudy, but not swollen. He said "Well, perhaps it was not swollen because of the eye drops."
He then looked into my sons eye, and said it was 50% better, and was only a little swollen now. He said his cornea was less dense, the stroma part.

I thought, WTF? The specialist said it was NOT swollen! It seemed this guy was trying to convince me that the drops he prescribed had helped, and he did the right thing by prescribing them himself. It seemed he was trying to make me feel as if I didn't know anything, and I should believe whatever he said. Thank you, Chris, for further explaining why not just anyone should prescribe those types of eye drops. This optometrist tried to make it seem as if there was no harm in doing it. I can't help but to wonder if those drops are what made my sons cornea a bit cloudy.
He also kept saying that he had no problem with getting a second opinion. Then he said that if I wanted to go even further and get a third opinion, that there are eye specialists that specialize in only the cornea, and I could take my son there if I like. (He really sounded like he was being a smart ass)

So that's what happened. I did not like the way this guy talked to me as if I was stupid, and I will not be taking any of my children back there. I have a different optometrist I will be taking them to from now on.

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