Corneal Dystrophies

Corneal  Dystrophies

By Dr. Gabriel Dery
Retired eye doctor

 

Corneal Dystrophies

After I gave the lecture on Ocular Diseases “What you should know about your eyes” on January 10th 2016 (at Open Circle), I was asked all sorts of questions but I was also asked to write an article about Corneal Dystrophies.

A few friends, with corneal dystrophies, came to ask me to see them and to diagnose their corneal problems. They really wanted me to examine them and advise them of what to do with their problems. But before I discuss any of my friends’ problems let us first find out about Corneal Dystrophy. What does it mean?

Corneal dystrophies are a group of genetic, often progressive, eye disorders in which abnormal material often accumulates in the clear (transparent) outer layer of the eye (cornea). Corneal dystrophies may not cause symptoms (asymptomatic) in some individuals; in others they may cause significant vision impairment. The age of onset and specific symptoms vary among the different forms of corneal dystrophy. The disorders have some similar characteristics; most forms of corneal dystrophy affect both eyes (bilateral), progress slowly, do not affect other areas of the body, and tend to run in families. Most forms are inherited.

The symptoms of corneal dystrophies result from the accumulation of abnormal material within the cornea, the clear outer layer of the eye. The cornea serves two functions; it protects the rest of the eye from dust, germs and other harmful or irritating material, and it acts as the eye’s outermost lens, bending incoming light onto the inner lens, where the light is then directed to the retina

The retina converts light to images, which are then transmitted to the brain. The cornea must remain clear (transparent) to be able to focus incoming light. Such material may cause the cornea to lose its transparency potentially causing loss of vision or blurred vision.

A symptom common of many forms of corneal dystrophy is:

Recurrent corneal erosion can cause discomfort or severe pain, an abnormal sensitivity to light (photophobia), the sensation of a foreign body (such as dirt or an eyelash) in the eye, and blurred vision.  It needs immediate attention.

The presence of a corneal dystrophy may be found incidentally during a routine eye examination. A diagnosis may be confirmed by a thorough clinical evaluation. The treatment of corneal dystrophies varies. Individuals who do not have symptoms (asymptomatic) or only have mild symptoms may not require treatment and may instead be regularly observed to detect potential progression of the disease. Specific treatments for corneal dystrophies may include: Eye drops, Ointments, Lasers, Corneal Transplant.

In individuals with significant associated symptoms a corneal transplant may be necessary. Corneal transplants have been highly successful in treating individuals with advanced symptoms of corneal dystrophies.

I will not enumerate all corneal dystrophies but I will discuss one patient seen here in the village: a female in her sixties, who already did have  a corneal transplant in one eye, and was concerned about having another corneal transplant in the other eye.  The examination, effectively, revealed some corneal abnormalities in the endothelium, which is the last inner layer of the cornea.  The fact that her corneal damages were located off center of the cornea her vision was still good and no double vision, which is one of the most current problem induced by this problem.  She was reassured that an eminent corneal transplant will not be necessary and to wait a few more months until it will become a real problem.

It is very good to be examined on a regular basis to make sure that the health of your eyes is free of any potential eye diseases.

 

Ojo Del Lago
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