The Need for Improved Therapeutic Approaches to Protect the Cornea Against Chemotoxic Injuries

Cornea, a highly specialized transparent tissue, is the major refractive element of the eye. The cornea is highly susceptible to chemotoxic injury through topical exposure to vapors, microparticles, and aqueous drops, as well as through systemically absorbed chemicals that access the cornea via tear film, aqueous humor, and limbal vasculature. Corneal injury activates a carefully orchestrated series of repair processes capable of resolving minor lesions over time, but it often fails to overcome the menace of moderate, severe, and chronic injuries and secondary pathophysiologies that permanently impair vision. The most serious complications of chemical injuries—persistent corneal edema, neovascularization, scarring/haze, limbal stem cell deficiency, and corneal melting—often manifest over months to years, suggesting that a better understanding of endogenous regenerative mechanisms of corneal repair can lead to the development of improved treatments that may attenuate or prevent corneal defects and protect vision.