Cornea – The Basics

Dr. Cavanaugh is a fellowship-trained corneal surgeon with experience in all types of corneal conditions

What is the Cornea?

The cornea is the clear dome-shaped outer covering of the eye over the iris (the colored part) and the pupil. It is often referred to as the “window of the eye”. The cornea acts as the eye’s first curved focusing structure and has two-thirds of the focusing power of the eye. Since light is first passed through the cornea, it is necessary to have both a clear and a smooth cornea for you to see well. The cornea has five main layers and disease can occur in any or all of the five layers. From the outside to the inside, these layers include: Epithelium, Bowman’s Membrane, Stroma, Descemet’s Membrane, and Endothelium.

Treatments for Corneal Disease

Treatment is tailored to the individual disease and the individual patient. The underlying disease and contributing problems need to be addressed. Depending on the condition, treatments might include medications, laser treatment, corneal transplantation, or other surgery. Treatment modalities are often determined by which layer(s) of the cornea are involved.

Who Needs a Corneal Transplant?

Vision will be blurred or reduced if the cornea becomes cloudy, swollen and/or scarred. This occurs as a result of injury, degeneration, infection or inherited dystrophy. Examples of such conditions are:

  • Hereditary corneal dystrophies: Fuchs’, Lattice, Granular, Macular
  • Keratoconus: cone-like steepening of the cornea
  • Scarring after infections: herpes virus, bacterial, fungal, other
  • Scarring after injury
  • Corneal failure after other eye surgery such as cataract surgery
  • Rejection after corneal transplant

Eye Banking 101: How We Obtain your Donor Cornea

In the Midwest, we are fortunate to have an excellent eye bank system. The Saving Sight eye bank supplies corneal tissue to many transplant recipients in the Midwest. As a past Medical Director of the Kansas City Eye Bank, Dr. Cavanaugh was instrumental in helping forge what is now the Saving Sight organization. Because of this network and our close relationship with the Saving Sight, we are now able to schedule corneal transplants like any other surgery and there is generally no waiting list.

The Kansas City branch Saving Sight is the headquarters and functions as the DSAEK tissue processing center for the entire Midwest. Dr. Cavanaugh was asked to oversee the training and certification of the technicians and the new state of the art tissue preparation facility. View Dr. Cavanaugh’s recognition from Saving Sight. In this facility, the donor cornea is precisely split so that only the posterior (back) layers can be transplanted.

Your donor cornea is received through the Saving Sight from a person who has recently passed away. This person’s family has decided to allow their loved one to continue living by donating usable tissue. You may receive a cornea from a local donor or an out-of-state donor. All tissue is tested for the HIV/AIDS virus, and Hepatitis B and C. Strict screening criteria must be met before tissue qualifies for transplantation. When the eye bank receives the corneas, they call the doctors who have patients scheduled for surgery within the next few days and notify them of tissue availability. If Dr. Cavanaugh is unable to acquire suitable tissue for you, one of his staff will call you and reschedule your surgery for later. This occurrence is very uncommon.

Click here for more information on full thickness corneal transplants.