What Is a Corneal Scar?
A corneal scar, or corneal scarring, is a buildup of opaque fibrous tissue where healthy, transparent corneal tissue used to be, the result of the body's attempt to repair damage to the cornea. Scars elsewhere on the body heal and are forgotten. The cornea is different: it cannot tolerate incomplete repair, because any opacity sits directly in the path of light and affects vision.
Causes of Corneal Scarring
The usual causes are viral infections (herpes keratitis is a common cause in many countries; in Egypt, bacterial and fungal infection and injury are also very common), bacterial or fungal ulcers, traumatic injuries such as cuts and burns, very advanced keratoconus (acute hydrops), and some rare systemic diseases.
How Does a Corneal Scar Affect Vision?
Location matters more than anything. Peripheral scars away from the visual axis cause minimal or no impact. Scars in the central area affect visual acuity directly. Extensive thick scars mean significant loss of clarity, and usually a surgical solution.
How Is a Corneal Scar Treated?
Treatment follows the depth of the scar, in this order:
- Treat the underlying cause first. Antiviral or antibacterial medication addresses the infection that produced the scar.
- Wait for the eye to stabilise. Nothing surgical is decided while the eye is still inflamed.
- PTK for superficial scars. Laser phototherapeutic keratectomy can remove scarring that sits near the surface.
- DALK for deep scars with a healthy endothelium. The affected layers are replaced and the patient's own endothelium is kept.
- PKP when the scarring goes through the full corneal thickness.
When to be seen urgently. A chemical splash or a sharp injury to the eye needs an emergency department straight away. See an eye doctor within 24 to 48 hours for sudden severe pain, a sudden drop in vision, an infection with pus, or blurred vision after a previous corneal graft (possible rejection). PTK reaches only surface scars, and a graft needs regular follow-up to check for rejection.
Evaluating corneal scars requires careful specialist examination. Contact Dr. Ahmed Shaarawy's clinic.
See the full treatment ladder, from surface laser (PTK) to DALK and PKP, with prices and recovery times, on our corneal scar treatment page.
Sources and references
Peer reviewed and professional sources used in the medical review of this article:
- A Review of Corneal Blindness: Causes and ManagementTidke et al., 2022 · Cureus
- Regenerative Therapy for Corneal Scarring DisordersChandran et al., 2024 · Biomedicines
