How can an unhealthy cornea affect vision?

David R. Demartini, MD
The cornea is the clear window on the very front of the eye through which the pupil and the colored iris is visible. The cornea has two major functions: focus the light rays that come into the eye onto the retina and protection of the eye.
To focus the light and make a clear image on the retina, the cornea has to be exquisitely clear and without distortion. This happens because the cornea is constantly moistened and polished by the lids making its anterior surface as smooth as glass. The backside of the cornea has a special layer of pump cells (endothelium) that allow nutrition and clearing of the cornea without blood vessels that might blur vision.
Protection is provided by the cornea by its very numerous and sensitive nerve endings on its surface. This prevents injury because it leads to significant pain if scratched or injured. The cornea is also rigid without being brittle so that it holds its shape even under extreme conditions. This rigidity keeps the image in focus.
If disease or injury destroys any of these functions then the cornea will not be clear causing the vision to be blurred.

If the cornea is injured, it may become swollen or scarred, and its smoothness and clarity may be lost. Scars, swelling or an irregular shape can cause the cornea to scatter or distort light, resulting in glare or blurred vision.

A corneal transplant is needed if:

  • Vision cannot be corrected satisfactorily with eyeglasses or contact lenses
  • Painful swelling cannot be relieved by medications or special contact lenses

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.