Patient Education

A growing library of easy-to-read informational pages about a host of common eye problems.

Medically Necessary Contact Lenses

Having trouble seeing a future past your vision problems?

KeratoconusFor some patients, their vision cannot be corrected with glasses. Most contact lens wearers think their contact lenses feel “visually” or “medically” necessary. However, “medically necessary contact lenses” are prescribed to provide vision that is better than glasses or soft contact lenses. To put things in perspective, some patients cannot see anything on the letter chart even with glasses or soft contact lenses. These patients usually face two options: undergo invasive surgery such as corneal transplantation or find the best available custom contact lens correction.


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Keratoconus is an uncommon condition in which the normally round, dome-like cornea (the clear front window of the eye) becomes thin and develops a cone-like bulge. Keratoconus literally translates into ”cone-shaped cornea.”


DSAEK Procedure


The cornea is made of five layers. The corneal endothelium is the inner most layer and helps keep the cornea clear by pumping water out of the stroma and keeping the level of water stable throughout the day and night. This layer is essential to keep the cornea a certain thickness and the vision clear.

Sometimes, the inner layer gets sick or diseased. For example, in Fuch’s Corneal Dystrophy, disease that is sometimes hereditary, the cornea endothelium gets sick and the cell count of the endothelium starts to decline at an early age. This early cell loss can sometimes be exacerbated by trauma or surgery, no matter of how perfectly the surgery went.

When the corneal endothelium can’t keep up with what it is supposed to do and the pump mechanism slowly fails, this can cause corneal edema which can lead to cloudy vision that can sometimes be cleared by drops and other therapies, but often requires surgery to fix the root of the problem.

Fuch’s Corneal Dystrophy

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The cornea is the clear, round window of tissue that covers the iris and lens of the eye. There are five layers to the cornea, the innermost being the endothelium (read about corneal anatomy here). This layer is made of a sheet of endothelial cells and is essential in keeping the cornea clear. They accomplish this by working as a pump to keep a regulated amount of water in the stroma (the middle layer of the cornea).

However, in a diseased state like Fuchs’ corneal dystrophy, the cornea can be cloudy, interfering with the ability of the cornea to focus light as it enters the eye. This can result in blurred, clouded vision that can diminish our ability to see clearly.

Corneal Transplant or “PKP/PK” (Penetrating Keratoplasty)

Corneal Transplant

Corneal transplant surgery involves the removal of a patient’s diseased or damaged cornea and replacing it with a healthy donor cornea. The cornea is the clear element at the front of the human eye, which begins to refract (focus) incoming light and pass it through to the inner eye. When the cornea becomes misshapen, cloudy, scarred or otherwise damaged, there are a variety of treatments available. An ophthalmologist resorts to a corneal transplant when other methods of treatment have been exhausted. The corneal transplant is the most commonly performed, and most successful, of all transplant surgeries.