Services
Corneal Disease
Expert diagnosis and management of diseases of the cornea, from medical treatment to advanced corneal transplant surgery.
What is Corneal Disease?
The cornea is the clear, dome-shaped front surface of the eye. It is the eye's primary focusing lens, contributing approximately two-thirds of the eye's total optical power. The cornea must remain perfectly clear and smoothly curved for good vision.
Corneal disease encompasses a broad range of conditions that affect the cornea's clarity, shape, or structural integrity. These conditions may cause blurred vision, pain, light sensitivity, and in severe cases, significant vision impairment. Treatment ranges from medical therapy and contact lens fitting to corneal transplant surgery.
Conditions Treated
Keratoconus
A progressive condition in which the cornea thins and bulges forward into a cone shape, causing irregular astigmatism and blurred vision. Managed initially with spectacles and rigid contact lenses. Corneal cross-linking can halt progression. Advanced cases may require corneal transplantation.
Keratoconus diagnosis and treatment at Northern Eye Consultants →Corneal Dystrophies
Inherited conditions affecting specific layers of the cornea. Fuchs endothelial dystrophy is the most common, causing progressive corneal oedema and vision loss due to endothelial cell failure. Other dystrophies include lattice, granular, and macular dystrophies. Surgery is required when vision is significantly impaired.
Corneal Infections (Keratitis)
Bacterial, fungal, viral (including herpes simplex and herpes zoster), and amoebic (Acanthamoeba) infections can cause serious corneal ulceration. Prompt diagnosis and targeted antimicrobial therapy are essential to preserve vision. Corneal scarring after infection may ultimately require transplantation.
Corneal Scarring
Scarring from previous infection, trauma, or inflammation causes loss of corneal clarity and reduced vision. The location and depth of scarring determines the appropriate management, which may include therapeutic contact lenses or corneal transplantation.
Bullous Keratopathy
Corneal oedema (waterlogging) resulting from endothelial cell failure — often after cataract surgery or as a consequence of Fuchs dystrophy. Causes painful blistering and cloudy vision. Endothelial keratoplasty (DSAEK or DMEK) is the treatment of choice.
Symptoms of Corneal Disease
- Blurred or distorted vision
- Halos and glare around lights
- Eye pain or foreign body sensation
- Redness and discharge
- Increased light sensitivity (photophobia)
- Frequent changes in glasses prescription
- Contact lens intolerance
Corneal specialist referrals
Dr MacIntyre welcomes referrals for all corneal conditions, including complex cases requiring transplantation.
Make an AppointmentSurgical Treatment Options
When medical management and contact lenses are no longer sufficient, corneal transplant surgery may be recommended. Dr MacIntyre performs all forms of corneal transplantation.
DSAEK
Descemet Stripping Automated Endothelial Keratoplasty
A partial-thickness transplant that replaces only the diseased inner cell layer (endothelium) of the cornea. The ideal treatment for Fuchs dystrophy and bullous keratopathy. Faster recovery than full-thickness transplant, with a smaller incision and reduced risk of graft rejection.
DALK
Deep Anterior Lamellar Keratoplasty
A partial-thickness transplant that replaces the front layers of the cornea while preserving the patient's own endothelium. Used for keratoconus and anterior corneal dystrophies where the endothelium is healthy. Has a lower risk of rejection than full-thickness transplant.
Penetrating Keratoplasty
Full-Thickness Corneal Transplant
The traditional full-thickness corneal transplant, indicated when the entire cornea is severely affected by scarring, infection, or disease involving multiple layers. A donor cornea disc replaces the patient's diseased cornea. Recovery takes longer than lamellar techniques.
Corneal Cross-Linking
Corneal cross-linking is a procedure used to halt the progression of keratoconus. Riboflavin (vitamin B2) eye drops are applied to the cornea and activated with ultraviolet A light, strengthening the corneal collagen fibres. Cross-linking does not reverse existing keratoconus but can prevent further deterioration, preserving the patient's own cornea and delaying or preventing the need for transplantation.
Our Corneal Disease Specialist
Dr Ross MacIntyre is an internationally trained corneal specialist with fellowship training at the Wilmer Eye Institute, Johns Hopkins University (Baltimore) and the Royal Victorian Eye and Ear Hospital. He is a staff specialist at the Eye and Ear Hospital with extensive experience in corneal transplantation.
Dr Ross MacIntyre
BA (Chemistry), MD, FRANZCO
Corneal, Cataract & Refractive Surgery
General Ophthalmology
Dr MacIntyre is an internationally trained expert in the area of corneal, cataract and refractive surgery. Dr MacIntyre completed his Bachelor of Arts degree in chemistry with Honours at Colgate University in New York, and his Doctor of Medicine with Honours at New York Medical College. After a transitional internship at Columbia University he completed his registrar training in ophthalmology at Brown University. He subsequently undertook subspecialty fellowship training in cornea, complex cataract, and refractive surgery at the Wilmer Eye Institute at Johns Hopkins in Baltimore. He pursued further training as a cornea fellow at the Royal Victorian Eye and Ear Hospital in Melbourne. During his training he has published articles in the medical literature and presented at both international and local scientific meetings. He is a diplomat of the American Board of Ophthalmology, a member of the Alpha Omega Alpha Honour Medical Society in the United States, and a fellow of the Royal Australian and New Zealand College of Ophthalmologists. Dr MacIntyre is a staff specialist at the Royal Victorian Eye and Ear Hospital, where he trains registrars and fellows, and provides public health care. He specialises in medical disease of the cornea and corneal transplant surgery.
Qualifications
- —BA (Chemistry)
- —MD
- —Diplomate American Board of Ophthalmology
- —FRANZCO
Fellowships
- —Wilmer Eye Institute, Johns Hopkins University
- —Royal Victorian Eye and Ear Hospital
Professional Memberships
- —Royal Australian and New Zealand College of Ophthalmologists (RANZCO)
- —American Academy of Ophthalmology
- —American Society of Cataract and Refractive Surgery
- —European Society of Cataract and Refractive Surgery
- —Cornea and Contact Lens Society of Australia
- —Alpha Omega Alpha Medical Honour Society (AOA)
Public Appointments
- —Staff Specialist, Royal Victorian Eye and Ear Hospital
Frequently Asked Questions
Can corneal disease be treated without surgery?
Many corneal conditions can be managed without surgery. Mild keratoconus is treated with rigid contact lenses, corneal infections are treated with antibiotic or antiviral drops, and corneal cross-linking can halt the progression of keratoconus non-surgically. Surgery is only recommended when medical treatments are no longer sufficient to maintain good vision.
What is a corneal transplant and will I need one?
A corneal transplant involves replacing all or part of the diseased cornea with donor tissue from an eye bank. Modern techniques such as DMEK and DSAEK replace only the affected layers rather than the full cornea, leading to faster recovery and lower rejection risk. Whether you need a transplant depends on the severity and type of your corneal condition — many patients never require surgery.
How long does recovery take after corneal surgery?
Recovery time varies by procedure. Endothelial transplants (DSAEK, DMEK) typically allow functional vision within 4–8 weeks, though full stabilisation takes 3–6 months. Full-thickness transplants (penetrating keratoplasty) have a longer recovery of 12–18 months, with suture removal over that period. Your surgeon will give you a personalised timeline based on the procedure performed.
Is corneal transplant surgery covered by Medicare and private health insurance?
Yes. Corneal transplant surgery is a Medicare-listed procedure, meaning the surgeon's fee and hospital costs are partially covered. With appropriate private health insurance (hospital cover), out-of-pocket costs are significantly reduced. The donor cornea itself is provided at no cost through the Lions Eye Donation Service. Our team can provide a fee estimate before your surgery.
What is the difference between DMEK and DSAEK?
Both are partial-thickness corneal transplants that replace only the inner cell layer (endothelium) of the cornea. DMEK uses a thinner layer of donor tissue and generally achieves better final vision, but is technically more demanding. DSAEK uses a slightly thicker graft and is a reliable alternative, particularly in complex cases. Dr MacIntyre will recommend the most appropriate technique based on your individual circumstances.
Refer to Our Corneal Specialist
Dr Ross MacIntyre welcomes referrals for all corneal conditions, including complex cases requiring transplantation. A GP or optometrist referral is required.