Certain conditions cause the corneal curvature to become abnormal, such as keratoconus. A computerized analysis of corneal curvature, called corneal topography, can detect small changes in corneal curvature. This analysis can help determine the cause of decreased vision and often the solution. The endothelial cells on the back surface of the cornea pump fluid out of the cornea to keep it clear. When these cells do not function properly, the cornea swells, the vision decreases, and pain can develop.
Specular microscopy can visualize the endothelial cells to help determine their health.
On the second Friday afternoon of the month a specialty clinic is staffed by a cornea specialist, an oculoplastics specialist and a dermatologist from Thomas Jefferson University Hospital to manage various conditions associated with severe scarring of the conjunctiva and cornea such as ocular cicatricial pemphigoid and Stevens-Johnson syndrome. These are rare but potentially visually disabling conditions that frequently have multi-system involvement necessitating a multidisciplinary approach for diagnosis and treatment. Oral therapy is frequently required using strong medications that need careful monitoring for side effects. Various surgical techniques are available to try to repair the ocular surface and maintain or improve vision. A normal, undamaged cornea is necessary for full vision.