Dua's layer

[1] It is hypothetically 15 micrometres (0.59 mils) thick, the fourth caudal layer, and located between the corneal stroma and Descemet's membrane.

A press release reported Dua as saying that the discovery meant "ophthalmology textbooks will literally need to be re-written.

[1][7] The understanding of diseases of the cornea, including acute hydrops, Descemetocele, and pre-Descemet's dystrophies, may be affected if the existence of this layer is confirmed.

Harminder Dua believes that from a clinical perspective, there are many diseases that affect the back of the cornea, which clinicians across the world are beginning to relate to the presence, absence, or tear in this layer.

[4] Dua hypothesizes that such a tear would allow water from inside the eye to pass through and cause fluid buildup.

By August 2013, reaction to the news in the medical world ranged from welcoming to skeptical, and there was "not as yet global academic support for a textbook change".

[5] Mark Terry, clinical ophthalmology professor at Oregon Health & Science University stated: "I applaud the fresh approach to corneal anatomy that Dr. Dua has taken, and I look forward to further documentation of the unique benefits of this layer in treatment.”[5] But Peter McDonnell, the director of the Johns Hopkins Wilmer Eye Institute and chief medical editor of the Ophthalmology Times, said that time was needed “to see if others can confirm the existence of this ‘new layer’ and its potential significance", and added that his own reading of Dua's paper was that "this is not a description of a new layer in the sense of how we think of the corneal layers".

"[6][10]Dua et al. responded that the first public presentation of the concept and evidence of a new corneal layer was introduced by Dua HS at two international meetings, UK and Italy, where images of the big bubble and of transmission electron microscopy showing the layer dating from 2005 were demonstrated and that the use of the term was regretted and with hindsight was probably not a good choice.