What is corneal dystrophy?

Corneal dystrophies are a group of over twenty genetic conditions which affect the cornea, the front part of the eye. The cornea is made up of five layers and they must be clear in order for you to see well. Water, nutrients and other matter usually pass through these layers but in the case of corneal dystrophies, one or more of these layers becomes water-logged and as result, the cornea becomes cloudy and vision blurs. This is gradual process and patients may not have any symptoms for many years.

What causes corneal dystrophy?

Corneal dystrophies are genetic and as such are commonly found to be hereditary. However, in some cases the cause is unknown. Fuch´s corneal endothelial dystrophy (FCED) is one type of corneal dystrophy which is related to the ageing process. Endothelial cells, which act like pumps, control the movement of water, nutrients and other matter through the layers of the cornea. In the normal ageing process, some of these endothelial cells are lost, slowing down this movement of matter. In patients of FCED, this loss of endothelial cells is accelerated meaning that the movement of matter is significantly reduced, leading to the layers of the cornea becoming built up, causing cloudiness and blurred vision.

What are the symptoms of corneal dystrophy?

The most common symptom of corneal dystrophy is cloudy or blurred vision. Some patients will notice a reduction in the clarity of their vision and glare, often worse in the morning. However, as the condition is characterised by a gradual build-up of matter, many patients do not notice the onset of symptoms and they are diagnosed at a routine optician’s appointment. Other signs that you may be suffering from corneal dystrophy are:

• corneal erosions: a consequence of corneal dystrophy where the outermost layer of the cornea becomes detached from the others, giving the patient mild to severe pain
• eyelid sticking to the eyeball
• sensitivity to light
• watery eyes
• dry eyes
• the feeling of having something in your eye
• pain in the eye

How is corneal dystrophy treated?

Treatment options for corneal dystrophy vary according to the severity and the progression of the condition in the patient. If the patient has a good level of vision, it may be possible to monitor the condition with regular check-ups, without resorting to treatment.

Mild symptoms can be treated by eye drops designed to draw out excess water from the cornea, clearing the build-up and as result improving vision. Water logging on the outermost layer of the cornea can result in small blisters forming. Should one of these blisters burst, it can cause pain and irritation. In this case, special ophthalmologists can provide eye drops or a special contact lens, which acts like a plaster, to ease irritation.

To improve vision in patients with more severe cases of vision loss, corneal transplants may be considered. In these cases, either an entire cornea may be transplanted or just some endothelial cells, to help improve the pump function within the layers of the existing cornea.

What type of doctor treats corneal dystrophy?

A specialist ophthalmologist treats corneal dystrophy.