Corneal dystrophies and opacifications
Corneal Dystrophy is a collective term referring to several conditions that cause a buildup of abnormal material in the corneal layer of the eye.
These disorders can lead to loss of vision and might necessitate a corneal transplant in severe cases. While some forms of Corneal Dystrophy develop in early childhood, others may not appear until middle age.
What Is Corneal Dystrophy?
Corneal Dystrophy encompasses a group of genetic eye disorders characterized by the abnormal accumulation of substances in the clear, outer layer of the eye called the cornea. These accumulations can cause a range of visual impairments and discomfort.
The dystrophies can be classified by their genetic cause, by the corneal layer affected, or by the material deposited. Common types include Fuchs’ dystrophy, keratoconus, and lattice dystrophy.
Most Corneal Dystrophies are inherited, non-inflammatory, and tend to affect both eyes. The progression of these conditions varies, and while some forms may cause significant vision impairment, others may have little to no effect on vision.
Types of Corneal Dystrophy
Corneal dystrophy comprises various types, each affecting different parts of the cornea and manifesting unique symptoms.
FUCHS’ ENDOTHELIAL DYSTROPHY
Affects the endothelium layer of the cornea, leading to symptoms like blurred vision and discomfort. Treatment may include eye drops or corneal transplant.
KERATOCONUS
Begins during adolescence, affecting the stromal layer. Symptoms include progressive distortion of vision, with treatment ranging from specialized contact lenses to surgery.
MAP-DOT-FINGERPRINT DYSTROPHY
This type affects the epithelium layer, causing symptoms like eye pain and glare sensitivity. Treatment typically involves lubrication or surgical removal of the affected epithelium.
LATTICE DYSTROPHY
Characterized by clouding and opacity in the stromal layer, resembling a lattice pattern. Treatment may include laser therapy or surgical intervention.
GRANULAR DYSTROPHY
Also affects the stromal layer, beginning in childhood. Granular deposits within the cornea cause visual impairment, and treatment may require surgical intervention.
MACULAR DYSTROPHY
Affects the stromal layer, leading to opacity and vision loss. Treatment typically involves a corneal transplant.
Symptoms of Corneal Dystrophy
The symptoms of Corneal Dystrophy vary widely depending on the specific type and severity of the disorder. Common symptoms across different forms of Corneal Dystrophy may include:
Who Does Corneal Dystrophy Affect?
Corneal Dystrophy can affect individuals of all ages, genders, and ethnic backgrounds, though the prevalence and manifestation may vary depending on the specific type of dystrophy and individual factors.
Diagnosing Corneal Dystrophy
A routine eye examination can detect the development of corneal dystrophy. A full clinical examination is the best way to get an accurate diagnosis. This process will entail a patient history, especially determining if the patient has a family history of corneal dystrophy, and testing, like a slit lamp examination. With a slit lamp exam, a special microscope (a slit lamp) gives a doctor a high degree of magnification to study the buildup of particles and discover whether they are affecting corneal functions.
Certain genetic tests can diagnose the likelihood of specific corneal dystrophies developing, even before any symptoms present themselves.
Treating Corneal Dystrophy
How can corneal dystrophy be treated? Because there are many different types of the condition, treatment itself can vary.
People with asymptomatic corneal dystrophy (where there are no symptoms) or those who have mild symptoms might not require any treatment. Instead, it may be better for them to get regular checkups and examinations to see if the disease progresses to the point where treatment would be necessary.
Patients who require treatment might be given eye drops and ointments. For more serious cases, laser treatment and corneal transplants might be required. Recurrent corneal erosions (mentioned above) are usually dealt with via lubricating eye drops, antibiotics, ointments, or special contact lenses. If the erosions continue, a doctor might go a step further and perform corneal scraping or use excimer laser therapy, which can cut off abnormalities from the surface of the cornea (a procedure known as phototherapeutic keratectomy).
Patients who are in significant pain or suffering from vision loss might have to receive a corneal transplant. Also known as keratoplasties, these procedures are very effective in offering relief to patients who have advanced corneal dystrophy symptoms. Patients will likely have to continue receiving eye care for months after the procedure.
These disorders can lead to loss of vision and might necessitate a corneal transplant in severe cases. While some forms of Corneal Dystrophy develop in early childhood, others may not appear until middle age.
What Is Corneal Dystrophy?
Corneal Dystrophy encompasses a group of genetic eye disorders characterized by the abnormal accumulation of substances in the clear, outer layer of the eye called the cornea. These accumulations can cause a range of visual impairments and discomfort.
The dystrophies can be classified by their genetic cause, by the corneal layer affected, or by the material deposited. Common types include Fuchs’ dystrophy, keratoconus, and lattice dystrophy.
Most Corneal Dystrophies are inherited, non-inflammatory, and tend to affect both eyes. The progression of these conditions varies, and while some forms may cause significant vision impairment, others may have little to no effect on vision.
Types of Corneal Dystrophy
Corneal dystrophy comprises various types, each affecting different parts of the cornea and manifesting unique symptoms.
FUCHS’ ENDOTHELIAL DYSTROPHY
Affects the endothelium layer of the cornea, leading to symptoms like blurred vision and discomfort. Treatment may include eye drops or corneal transplant.
KERATOCONUS
Begins during adolescence, affecting the stromal layer. Symptoms include progressive distortion of vision, with treatment ranging from specialized contact lenses to surgery.
MAP-DOT-FINGERPRINT DYSTROPHY
This type affects the epithelium layer, causing symptoms like eye pain and glare sensitivity. Treatment typically involves lubrication or surgical removal of the affected epithelium.
LATTICE DYSTROPHY
Characterized by clouding and opacity in the stromal layer, resembling a lattice pattern. Treatment may include laser therapy or surgical intervention.
GRANULAR DYSTROPHY
Also affects the stromal layer, beginning in childhood. Granular deposits within the cornea cause visual impairment, and treatment may require surgical intervention.
MACULAR DYSTROPHY
Affects the stromal layer, leading to opacity and vision loss. Treatment typically involves a corneal transplant.
Symptoms of Corneal Dystrophy
The symptoms of Corneal Dystrophy vary widely depending on the specific type and severity of the disorder. Common symptoms across different forms of Corneal Dystrophy may include:
- Blurry Vision:
- Accumulations in the cornea can scatter light, leading to blurred or distorted vision.
- Glare or Halos: Some individuals may experience increased sensitivity to light, causing glare or halos around lights.
- Pain or Discomfort: Corneal erosions, a common feature in some dystrophies, can cause significant pain or a gritty sensation in the eyes.
- Clouding of the Cornea: This can cause a decrease in visual clarity and might progress to significant vision loss in severe cases.
- Color Changes in the Cornea: Certain dystrophies may lead to visible changes in the color or transparency of the cornea.
- Frequent Changes in Prescription: Some individuals might notice a recurrent need to update their prescription for glasses or contact lenses.
Who Does Corneal Dystrophy Affect?
Corneal Dystrophy can affect individuals of all ages, genders, and ethnic backgrounds, though the prevalence and manifestation may vary depending on the specific type of dystrophy and individual factors.
- Age Factor: Some types of Corneal Dystrophy may manifest in childhood, while others may not become apparent until later in life. The age of onset can vary widely.
- Genetic Factors: Many Corneal Dystrophies have a genetic component, meaning that they can run in families. A family history of Corneal Dystrophy might increase an individual’s risk.
- Gender Differences: Certain forms of Corneal Dystrophy may show differences in occurrence or severity between males and females.
- Environmental Factors: Though primarily a genetic disorder, environmental factors such as injury or other eye conditions might exacerbate or trigger the symptoms of Corneal Dystrophy in some individuals.
- Ethnic and Geographical Differences: The prevalence of specific types of Corneal Dystrophy may vary among different ethnic groups and geographical regions.
Diagnosing Corneal Dystrophy
A routine eye examination can detect the development of corneal dystrophy. A full clinical examination is the best way to get an accurate diagnosis. This process will entail a patient history, especially determining if the patient has a family history of corneal dystrophy, and testing, like a slit lamp examination. With a slit lamp exam, a special microscope (a slit lamp) gives a doctor a high degree of magnification to study the buildup of particles and discover whether they are affecting corneal functions.
Certain genetic tests can diagnose the likelihood of specific corneal dystrophies developing, even before any symptoms present themselves.
Treating Corneal Dystrophy
How can corneal dystrophy be treated? Because there are many different types of the condition, treatment itself can vary.
People with asymptomatic corneal dystrophy (where there are no symptoms) or those who have mild symptoms might not require any treatment. Instead, it may be better for them to get regular checkups and examinations to see if the disease progresses to the point where treatment would be necessary.
Patients who require treatment might be given eye drops and ointments. For more serious cases, laser treatment and corneal transplants might be required. Recurrent corneal erosions (mentioned above) are usually dealt with via lubricating eye drops, antibiotics, ointments, or special contact lenses. If the erosions continue, a doctor might go a step further and perform corneal scraping or use excimer laser therapy, which can cut off abnormalities from the surface of the cornea (a procedure known as phototherapeutic keratectomy).
Patients who are in significant pain or suffering from vision loss might have to receive a corneal transplant. Also known as keratoplasties, these procedures are very effective in offering relief to patients who have advanced corneal dystrophy symptoms. Patients will likely have to continue receiving eye care for months after the procedure.
Corneal opacity is a disorder of the cornea that occur due to scarring or clouding of the normally clear and transparent cornea. It means loss of normal transparency of cornea. Corneal clouding stops the light from passing through the cornea to the retina and therefore results in decreased vision.
Corneal opacity can be a complication or result of other eye problem. There are so many eye disorders which can lead to clouding of cornea if not treated properly or become severe.
Cornea can loss its transparency due to various reasons and it majorly occurs due to some disorders of eye that eventually leads to corneal opacity. The causes of corneal opacity include the following:
Infection of the cornea or other adjoining parts
- Conjunctivitis
- Keratitis
- Herpes simplex virus
- Measles
- Contact lens-related infection
Injury to the eye
- From force, such as a poke in the eye
- From a chemical agent
- From some object like sand or dust
- Something striking the eye, such as a tree branch
- Radiation injury from the sun, sun lamps, welding, or sun reflected on snow
Certain eye diseases
- Irido-corneal endothelial syndrome
- Pterygium
- Stevens-Johnson syndrome
- Corneal dystrophy
Inflammation
Healed corneal wounds or ulcers
Wearing contact lenses for a long period of time
Congenital opacities may occur as developmental anomalies
Although there are so many reasons or eye disorders that can lead to corneal opacity but still some risk factors increases the chances of development of corneal opacity.
- Vitamin A deficiency
- Foreign bodies striking the eye
- Keratoconus
- Stevens-Johnson syndrome
- Congenital corneal abnormalities
When cornea becomes opaque, it causes varied symptoms in the eye that are very uncomfortable including:
- Near sightedness
- Farsightedness
- Astigmatism
- Eye redness
- Eye pain
- Swelling of the eye
- Excessive tearing
- Blurred vision
- Eye irritation
- Sensitivity to light
- Sensation of something in the eye
- Eye discharge
- Milky or cloudy or incompletely transparent area on the cornea
- Vision decrease or loss
Diagnosis of corneal opacity requires complete medical history and a thorough eye examination by an ophthalmologist.
Treatment typically depends upon the cause and severity of the opacity and may include any of the following:
- Patching the eye
- Using a temporary or special contact lens or Cosmetic coloured contact lens
- Antibiotic, antibacterial, antifungal, or steroidal eye drops or ointments
- Topical or oral antiviral medication
- Phototherapeutic keratectomy (laser surgery)
- Optical iridectomy
- Keratoplasty
- Intacs implants
- Cornea transplant
- Phototherapeutic keratectomy (PTK)