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Diffuse Lamellar Keratitis (DLK)

A rare complication of LASIK, diffuse lamellar keratitis is a sterile irritation that occurs when foreign material gets lodged underneath the corneal flap. If untreated, DLK can lead to permanent vision loss.

DLK usually develops within the first week following LASIK surgery and is easily observed by your eye surgeon using a slit lamp microscope. Under a slit lamp, the condition appears like tiny waves of sand in your cornea. As a result, the condition has been nicknamed “Sands of the Sahara.”

Symptoms of DLK

Patients suffering from DLK often experience:

  • Pain
  • Blurred vision
  • Sensitivity to light
  • Sensation of a foreign object in your eye

Stages of DLK

There are four stages of diffuse lamellar keratitis:

  • Stage 1 – This stage generally appears shortly after surgery and consists of the presence of foreign matter in the periphery of the corneal flap. At this point, the central cornea is not affected.
  • Stage 2 – Foreign material migrates to the central part of your visual axis. This stage occurs a few days after the condition starts developing. As dense clumps of cells collect on your central visual axis, the disorder begins transitioning into stage 3.
  • Stage 3 – In this stage, you will generally experience a 1- or 2-line loss of visual acuity. Your eyes may begin to develop permanent scarring if they are not treated.
  • Stage 4 – At this point, the condition has become very severe. Patients often experience stromal melting and permanent scarring. Central tissue loss may lead to the development of hyperopia in your vision. It is rare that DLK progresses to this stage without treatment.

Treatment of DLK

treatment generally consists of anti-inflammatory eye drops that must be used frequently for several months. Your eye surgeon may also choose to lift up the corneal flap and rinse the treatment area in order to flush out any foreign substances lodged in the region.

Early diagnosis and prompt treatment is crucial to preventing permanent vision loss. When properly treated, patients rarely experience permanent damage.

While DLK most commonly develops immediately following surgery, it is possible for it to occur months or years later if you suffer trauma to the eye that causes material to enter your corneal flap. It is always a good idea to err on the side of caution and get evaluated by your eye surgeon after sustaining any serious eye trauma.

Please contact an eye doctor in your area to learn more about diffuse lamellar keratitis.

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