Your Eyes and Cornea Problems
What Conditions Can Damage the Cornea? continued...
There are more than 20 corneal dystrophies, diseases that can cause structural problems with the cornea. Some of the most common are:
Map-dot-fingerprint dystrophy is the abnormal appearance of the basement membrane of the epithelium of the cornea. As this membrane that separates the epithelium and stroma grows irregularly (thicker in some places, thinner in others), irregularities in the cornea appear, resembling maps, dots, and small fingerprints.
Map-dot-fingerprint dystrophy usually affects adults over age 40. It is usually painless and causes no vision loss, and can improve without treatment. In some cases, however, epithelial erosion may occur. Epithelial erosion can expose the nerves lining the cornea, causing severe pain, particularly when awakening in the morning. The cornea's normal curvature may be altered causing astigmatism and nearsightedness/farsightedness.
As the cornea is altered, vision may be blurry and accompanied by:
- Moderate to severe pain
- Increased sensitivity to light
- Excessive tearing
- A feeling that something is in your eye
Treatment may include an eye patch, a bandage soft contact lens, eye drops, ointments, or removal of the loose abrading corneal epithelium as an “in-office” minor procedure.
Fuchs' dystrophy is an inherited condition in which there is gradual deterioration of endothelial cells. As these cells decrease in number and function over time, the cornea is less capable of removing water from the stroma, causing it to swell and distort vision. Haze and small blisters on the corneal surface may also appear.
As a slowly progressing disease, signs of Fuchs' dystrophy begin to appear in people 30 to 40 years of age, but it doesn't normally affect vision until about 20 years later. It is more common in women than in men.
An early sign of Fuchs' dystrophy includes waking up with blurred vision that gradually clears up during the day. As the disease worsens, swelling becomes more consistent and vision blurs.
Treatment options include:
- Eye drops/ointments
- Drying of swollen cornea with a hair dryer (at arm's length) two or three times per day
- Corneal transplant (full or partial)
Lattice dystrophy is characterized by the presence of abnormal protein fibers throughout the stroma. Although this condition can occur at any age, early changes can be seen in childhood.
Lattice dystrophy gets its name from the clear overlapping lines of proteins in the stroma. This can make the cornea cloudy and reduce vision. In some people, these proteins may cause epithelial erosion.
Treatment of lattice dystrophy includes:
- Prescription eye drops
- Eye patching
- Corneal transplant
Symptoms may disappear with treatment, but a corneal transplant may be required. Although results of this surgery are very good, lattice dystrophy may reappear in transplant patients.