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Corneal Dystrophy


What Is Corneal Dystrophy?

Corneal dystrophy is a group of genetic eye disorders that cause cloudy vision due to abnormal material building up in the cornea—the clear, outer layer of the eye. This buildup can affect one or more layers of the cornea and typically worsens over time. It is often bilateral, meaning it impacts both eyes, and can progress slowly without any external cause such as injury or infection.


Causes of Corneal Dystrophy

  • Corneal dystrophies are usually caused by genetic mutations inherited from parents.
  • Abnormal protein deposits accumulate in the cornea, leading to clouding and vision problems.
  • Specific gene defects affect corneal layers, disrupting normal transparency and structure.
  • Some dystrophies appear at birth, others develop later in life due to progressive degeneration.
  • Environmental factors and eye injuries rarely cause corneal dystrophies but may worsen symptoms.
  • Family history is a key risk factor for most types of corneal dystrophies.


Types of Corneal Dystrophies

  • Corneal dystrophies are inherited disorders affecting the cornea’s clarity and structure.
  • Epithelial Dystrophies: Affect the outermost corneal layer; includes Meesmann and Reis-Bücklers dystrophies.
  • Stromal Dystrophies: Impact the thick middle layer; examples are Granular, Lattice, and Macular dystrophies.
  • Endothelial Dystrophies: Affect the innermost layer; Fuchs’ endothelial dystrophy is most common.
  • Symptoms include vision loss, pain, and recurrent corneal erosions.
  • Treatment varies from medication to corneal transplant depending on severity.


Symptoms of Corneal Dystrophy

  • Blurred or cloudy vision due to corneal opacity
  • Eye discomfort or pain, often mild to moderate
  • Increased sensitivity to light (photophobia)
  • Frequent tearing or watery eyes
  • Sensation of a foreign body or grit in the eye
  • Recurrent corneal erosions causing sudden sharp pain
  • Difficulty seeing clearly, especially in low light
  • Gradual vision loss in advanced cases


Diagnosis of Corneal Dystrophy

Diagnosis involves a comprehensive eye exam by an ophthalmologist. Tools such as slit-lamp microscopy, corneal topography, or genetic testing may be used to identify the type and severity of dystrophy. Early detection is key, especially for inherited forms, to monitor changes and manage symptoms effectively before they significantly impact vision.


Treatment Options for Corneal Dystrophy

  • Mild cases may require no treatment, just regular monitoring.
  • Eye drops or ointments can help reduce discomfort and inflammation.
  • Contact lenses, especially special soft or scleral lenses, improve vision and comfort.
  • For advanced cases, procedures like phototherapeutic keratectomy (PTK) remove damaged layers.
  • Corneal transplant (keratoplasty) is an option if vision is severely affected.
  • Regular follow-up with an eye specialist is essential to manage symptoms effectively.


When to Seek Medical Attention

You should consult an eye specialist if you notice persistent blurred vision, recurring eye pain, increased sensitivity to light, or a sensation of something in your eye. Early intervention can help slow the progression of corneal dystrophy and reduce the risk of long-term vision impairment or complications.


Preventing the Progression of Corneal Dystrophy

While you can't prevent inherited corneal dystrophy, regular eye exams can help monitor changes and start treatment early. Avoiding eye trauma, using prescribed eye drops, and following your doctor’s advice can help manage symptoms and maintain eye health. In some cases, genetic counseling may be helpful for families with a history of the condition.

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