A quantitative description of equilibrium and homeostatic thickness regulation in the in vivo cornea. II. Variations from the normal state.

The description of corneal mechanics and transport developed in part I and used there to describe normal corneal behavior is here applied to corneas whose properties or boundary conditions are abnormal. The predicted effects of changing intraocular pressure, aqueous concentration, and tear tonicity are examined, and these compare favorably with available experimental data. The periodic variation in tear tonicity which accompanies the sleep-wake cycle prevents the cornea from achieving a true steady state, but a time-average steady state, about which corneal behavior oscillates, can be defined. The in vivo effects of endothelial dystrophy and epithelial removal are explained, and it is suggested that the epithelial sodium pump may act homeostatically to maintain corneal thickness in the face of ambient temperature variations. Part II concludes with a discussion, from the standpoint of the present theory, of the role of metabolically coupled water transport in the maintenance of the normal corneal thickness.