About The Cornea
The cornea is the outermost structure of the eye. When a cornea is healthy, it is transparent in appearance and maintains a natural, curved shape. This rounded shape allows light to bend and accurately focus on the retina, which produces good, clear vision. However, when if the cornea becomes misshapen or develops cloudy spots, this can cause your sight to diminish.
To ensure that your cornea and overall eye health is kept in check, it's imperative that you attend annual or bi-annual eye examinations with an eye doctor in your area. Our skilled team of ophthalmologists and optometrists in Billings, MT offer comprehensive services for patients with a range of vision issues and concerns. Contact Vance Thompson Vision and get in touch with a member of our staff to keep your ocular health in great shape.
"The staff is friendly, professional, patient and kind. They were thorough and explained everything to me. They made sure that they answered all of my questions. I was an individual, not just another patient."- D.V. / Google / Sep 26, 2019
"My experience at Vance Thompson Vision was very positive. The staff was very cordial and professional and Dr Swann evaluated my situation thoroughly and based on dealing with my glaucoma 20+ years I would say very accurately. Thank you. I would highly recommend them."- A.M. / Google / Sep 25, 2019
"I've heard Susan DeGroot speak of their charity work overseas and am simply amazed by the number of people who they help with vision issues. If and when I decide to get corrective surgery, there is no question where I'm going."- K.B. / Google / Apr 12, 2019
"The very best at what they do!! I am more than impressed with Vance Thompson Vision and Dr. Russell Swan! 10⭐'s"- J.M. / Google / Sep 06, 2019
"I had a PRK surgery done here and had THE best experience! Every staff member is extremely caring, professional, and knowledgeable and they go above and beyond! Dr. Swan texted me the night after my surgery to make sure I was doing ok and answered my questions. They have been very good about working with me as I don’t live in Bozeman and had to travel for my appointments and surgery. When you choose Vance Thompson Vision, you are choosing the best care! Highly recommend!"- K.C. / Google / Aug 23, 2019
Candidates for Consultations
If you have noticed a decrease in your quality of vision, we encourage you to visit our Billings, MT office for a consultation. Many corneal conditions, such as keratoconus, can only be diagnosed during a thorough ocular assessment. Depending on your unique situation, our eye center offers a range of surgical and nonsurgical solutions to improve your vision and restore your eye health.
Evaluation & Diagnosis
After you have scheduled your appointment at Vance Thompson Vision, you will arrive at the pre-determined time to receive your eye examination. During your evaluation, we will look for signs of corneal abnormalities, such as cloudy spots, rough patches, or an irregular (oblong) shape. We will also ask you about your symptoms, personal medical history, family history, and perform a range of comprehensive diagnostic tests. Our highly trained ophthalmologists and optometrists utilize only the best in technology that the vision industry has to offer.
There are many corneal diseases, including keratoconus, that have primarily genetic risk factors, but many conditions can also occur from injury or trauma to the cornea due to aggressive eye rubbing and other habits. Individuals with an unhealthy cornea often notice a reduction in sight, sensitivity to light, blurry vision, eye irritation, swelling around the eyes, or nighttime glares. However, these side effects can be improved or corrected with certain surgical or nonsurgical solutions to improve the appearance of the cornea and enhance your overall eye health.
There are a range of treatment options available for men, women, and even teens experiencing difficulties with their vision due to an unhealthy or damaged cornea. Some of the conditions we address and treatments we offer include:
Keratoconus is a corneal disorder characterized by the weakening of corneal tissue, which causes the cornea to bulge outward and adopt an oblong shape. This misshapen appearance causes a range of vision issues, such as blurriness, distortion, and glares, and can make reading, driving, and watching television difficult. When treated, these negative sight effects can diminish or become resolved altogether. The treatment you receive for keratoconus will depend on the severity of your unique condition. Some patients may notice an improvement with prescription glasses or contact lenses, but those in a further-along phase of the disease will require more advanced solutions.
Our ophthalmologists may recommend corneal cross-linking for men, women, or teens who are in the earlier stage of the condition as a preventive measure. Corneal cross-linking serves to enhance the strength of the fibers in the eye and may reduce your likelihood of requiring a surgical procedure later on. Other treatment options considered for keratoconus include corneal transplants and Intacs® corneal implants.
Corneal cross-linking is a minimally invasive treatment that utilizes UV light and riboflavin to promote the strengthening of the fibers in the cornea. This procedure is often performed as a solution for ectasia, which is a disease associated with an irregularly shaped outer eye surface. Patients with ectasia possess corneas that bulge outward, protrude, and adopt a cone-like shape. This disease can develop in men and women who suffer with keratoconus and/or PMD (pellucid marginal degeneration), which are corneal disorders characterized by a thinning or weakening of the cornea tissue. Ectasia causes corneal tissue to protrude and bulge out at its weakest points, which can dramatically diminish a person's vision quality.
Corneas have natural cross-linking between collagen fibers in order to preserve their shape, strength, and function. Ectasia can develop when there are not enough links present to encourage proper stability, which results in cornea irregularities. To address this issue, corneal cross-linking uses riboflavin and UV light to create more of these collagen cross-links and encourage proper corneal health. During corneal cross-linking, collagen fibers are chemically bonded to slow down or stop the thinning process and restore clear vision.
Cornea cross-linking can also be considered for patients in the earlier stages of keratoconus to strengthen the corneal fibers, slow down the progression of the disease, and prevent the need for more invasive surgeries later on.
- Fuchs' Dystrophy:
A hereditary disorder, Fuchs' dystrophy impacts the inner layer of the cornea (called the endothelium) and causes it to deteriorate, which results in corneal swelling. The cells of the endothelium control the amount of fluid in the eye by expelling the excess and maintaining a proper amount. However, when there are fewer endothelial cells than necessary, fluid can begin to build up in the cornea. As this excess fluid causes the corneal to swell, the individual will experience reduced vision. When Fuchs' dystrophy advances into more severe stages, blisters can develop throughout the cornea; this is a condition known as bullous keratopathy.
Currently, there is no known preventive care treatment for Fuchs' dystrophy. Our skilled ophthalmologists at Vance Thompson Vision will assess the stage of your condition and determine which treatment technique may be your best option. Reducing the amount of excess fluid from the eye using hypertonic drops is typically not an effective long-term solution, but this can be tried for individuals in the earlier phases of the disorder.
For patients with both Fuchs' dystrophy and high eye pressure, eye drops to treat glaucoma may help reduce inner ocular pressure. Since having high eye pressure can lead to Fuchs' dystrophy progressing further, maintaining a low or proper ocular pressure is essential.
When Fuchs' dystrophy begins to dramatically hinder your vision, your best option for relief may be a corneal transplant, either full or partial. Some partial-thickness corneal transplant techniques include DSEK and DMEK, which replaced the damaged cells while maintaining the integrity of the outer layer of the eye.
- Partial-Thickness Corneal Transplant (DSEK and DMEK):
DSEK (Descemet's Stripping Endothelial Keratoplasty) and DMEK (Descemet's Membrane Endothelial Keratoplasty) are partial-thickness corneal transplant techniques that utilize donor tissue to replace the two innermost layers of the cornea. These treatments offer an innovative transplant technique for patients who have damage in the endothelium rather than the entire cornea.
For partial-thickness transplants, our ophthalmologists first remove the damaged endothelial layer of the cornea. Once this is done, we then create a small incision to place the donor tissue into its ideal position. From there, we utilize either gas or an air bubble to unfold the donor cornea, allowing it to lay correctly. Once the transplant has been achieves, one or two stitches may be needed to seal the incision; but, in most cases, it will heal on its own.
Typically, DMEK is the more common technique for partial-thickness corneal transplants. Men and women with significantly damaged corneas (as a result of conditions like Fuchs' dystrophy) will notice great improvements with their vision and eye health after DMEK.
DSEK shares a lot of similarities with DMEK, as they are both partial-thickness corneal transplant techniques that don't require the removal and replacement of the entire cornea. DSEK serves to replace the affected endothelial layer to improve a patient's sight acuity and overall eye health.
- Cornea Transplant:
Cornea transplants are invasive but incredibly effective surgeries that utilize donor tissue to replace diseased or damaged corneas and restore a patient's eye health and clear vision. Individuals with deteriorated corneal tissue that has diminished their vision could qualify to receive this treatment at Vance Thompson Vision in Billings, MT.
During cornea transplant surgery, the centermost portion of the cornea (also called the button) is delicately removed and replaced with a healthy donor graft. Once the donor tissue is placed, one of our skilled ophthalmologists will then stitch it in place. Patients who receive cornea transplants typically experience high success rates, as well as improved vision and restored eye health. Although this surgery does require a lengthy recovery time, the advantages are often well worth it.
Assess Your Cornea at VTV
Our team of board-certified and board-eligible ophthalmologists and optometrists at Vance Thompson Vision have garnered national recognition for their commitment to providing exceptional improvements to our patients' sight and overall eye health. If you are experiencing difficulties seeing, such as blurry or distorted vision, or even discomfort and irritation in and around the eyes, we encourage you to contact our Billings, MT office and schedule your comprehensive eye examination today. Our staff has many years of combined experience in treating a range of cornea disorders and diseases, including keratoconus.