Sarvkesta

Sarvkesta is the Estonian term for the cornea, the transparent front part of the eye that covers the iris, pupil, and anterior chamber. It contributes about 43 diopters of refractive power and is essential for focusing light onto the retina. The cornea is avascular, receiving nutrients from the tear film and the aqueous humor, and is densely innervated by sensory nerves, giving it a high sensitivity to touch and injury.

Anatomically, the cornea comprises five layers: the epithelium, Bowman's layer, the stroma, Descemet's membrane, and the endothelium. The epithelium serves as a protective barrier and helps maintain the tear film. The stroma, which makes up most of the cornea’s thickness, provides strength and transparency through a regular arrangement of collagen fibers. Descemet's membrane and the endothelium form a basement membrane and a pumping layer, respectively; the endothelium helps keep corneal hydration balanced to preserve clarity. The cornea is normally free of blood vessels, with nourishment supplied by tears and aqueous humor. Corneal nerves provide a sensitive feedback mechanism that protects the eye.

Common conditions affecting the sarvkesta include keratitis (bacterial, viral, or fungal infections), corneal ulcers, and keratoconus (thinning and protrusion of the cornea). Corneal dystrophies, such as Fuchs’ endothelial dystrophy, can compromise transparency and vision. Injury, contact lens wear, dryness, and autoimmune processes can also affect the cornea's health.

Diagnosis typically involves slit-lamp examination, corneal topography, and pachymetry to measure thickness. Treatments range from medications (antibiotics, antifungals, anti-inflammatories) to preserve or restore function, to surgical options such as corneal transplant procedures. Penetrating keratoplasty replaces the full thickness; endothelial keratoplasty (DSAEK, DMEK) targets the posterior layers; lamellar keratoplasty preserves healthy anterior tissue. In severe cases, a keratoprosthesis may be considered.