Corneal Degenerations and Dystrophies: Understanding and Managing Progressive Eye Conditions

Introduction 

Corneal degenerations and dystrophies are a group of progressive eye conditions that affect the clear front surface of the eye (cornea). These conditions result in changes in the structure and function of the cornea, leading to decreased vision and other visual symptoms. In this article, we will discuss the causes, symptoms, and management of corneal degenerations and dystrophies.

Types of Corneal Degenerations and Dystrophies

  • Fuchs' dystrophy: A condition in which the cells that produce the clear fluid inside the cornea (endothelial cells) deteriorate over time
  • Keratoconus: A condition in which the cornea becomes thin and cone-shaped, leading to distorted vision
  • Map-dot-fingerprint dystrophy: A condition characterized by small, raised, and/or pigmented lesions on the cornea
  • Posterior polymorphous dystrophy: A rare condition in which the back layer of the cornea (posterior corneal stroma) is affected
  • Reis-Bücklers dystrophy: A rare condition characterized by small, raised, and/or pigmented lesions on the cornea

Causes 

The exact cause of corneal degenerations and dystrophies is not well understood. However, it is believed to be a combination of genetic and environmental factors. Some conditions, such as Fuchs' dystrophy and Reis-Bücklers dystrophy, are inherited in an autosomal dominant pattern.

Symptoms 

Symptoms of corneal degenerations and dystrophies can vary depending on the type and severity of the condition. Some common symptoms include:

  • Blurred vision
  • Glare and halos around lights
  • Photophobia (light sensitivity)
  • Distorted vision
  • Episodes of severe pain in the affected eye
  • The feeling of a foreign body in the eye
  • Redness of the eye

Diagnosis 

Diagnosis of corneal degenerations and dystrophies is typically made based on symptoms, a physical examination of the eye, and tests such as corneal topography, pachymetry, and endothelial cell count. Your doctor may also take a sample of fluid from the eye to test for the presence of bacteria or viruses.

Treatment 

Treatment for corneal degenerations and dystrophies will vary depending on the type and severity of the condition. Fuchs' dystrophy, for example, may require a surgical procedure called a endothelial keratoplasty (EK). Keratoconus may require special contact lenses or surgery to correct the distorted vision. Map-dot-fingerprint dystrophy and Posterior polymorphous dystrophy may require no treatment, or may require surgery in severe cases. Reis-Bücklers dystrophy may require surgery to remove the raised lesions on the cornea.

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