Medical and surgical management of corneal thinnings and perforations

The primary objective of treatment of a thin cornea is to maintain the integrity of the anterior chamber and to control the ocular inflammation. Available methods of therapy range from simple medical means, through soft contact lenses and tarsorrhaphy, to conjunctival flaps and keratoplasty. Once perforation has occurred, if the anterior chamber has not reformed in two to three days despite patching, soft contact lenses or adhesives should be tried; if not successful, the more complicated procedures such as glued-on hard contact lens, a blow-out patch graft, or penetrating keratoplasty must be undertaken to restore the integrity of the eye.