Thinning Corneas

Recently, I had a patient who had a thin spot in her cornea. This thin spot was a damaged area that was related to not having good sensation in the eye. When the front surface of the eye does not have good sensation, it does not have sufficient autoregulatory feedback loops to keep itself lubricated. Without good lubrication, the eye can be damaged and stay damaged–similar to a non-healing foot ulcer when the foot has poor sensation.

Unfortunately, she came in with emergent eye pain one day. I had previously warned her that, in the limit, these thin spots in the eye can thin all the way until there is a hole in the eye. Typically, when this happens, the eye becomes so deflated that the vision takes a drastic turn for the worse. When her vision testing had improved rather than worsened from her last visit, I breathed a sigh of relief.

But it was premature! When I looked at her eye, she sure enough had a little hole and had deflated. She needed to proceed with an emergency application of glue to the corneal surface that would reform the eye!