Dr. Orwa Nasser MD MPH - Corneal Dystrophy

Corneal Dystrophy

Corneal dystrophy refers to a group of inherited disorders that affect the clarity and structure of the cornea. These conditions cause abnormal deposits to accumulate in one or more layers of the cornea. Most corneal dystrophies affect both eyes and progress slowly over time. Symptoms and severity vary depending on the specific type and layer involved.

Symptoms: Symptoms may be mild in early stages and become more noticeable as the condition progresses.

    ·    Blurred or hazy vision.

    ·    Sensitivity to light.

    ·    Glare or halos around lights.

    ·    Foreign-body sensation.

    ·    Recurrent corneal erosion is causing sharp pain.

    ·    Gradual decline in visual clarity.

Causes:

·    Corneal dystrophies are caused by genetic mutations.

·    These mutations lead to accumulation of abnormal material within corneal layers.

·    Most forms are inherited in an autosomal dominant pattern.

·    They are not caused by infection, injury, or environmental exposure.

Diagnosis and Tests:

·    Diagnosis begins with a comprehensive eye examination.

·    Slit-lamp examination helps visualize corneal deposits and structural changes.

·    Corneal topography maps surface curvature irregularities.

·    Pachymetry measures corneal thickness. Genetic testing may be considered in certain cases.

Management and Treatment: Treatment depends on the specific dystrophy and severity of symptoms.

·    Laser treatment:

o   Phototherapeutic keratectomy can be performed to remove superficial deposits and smooth the cornea.

·    Surgical intervention:

o   Corneal transplantation can be performed in advanced cases.

o   Penetrating keratoplasty or lamellar keratoplasty may be selected depending on depth of involvement.

·    Observation:

o   Mild cases may only require regular monitoring.

·    Medical supportive care:

o   Lubricating drops relieve irritation.

o   Hypertonic saline may reduce corneal swelling.

o   Bandage contact lenses may help manage recurrent erosions.

Prognosis:

·    Prognosis varies depending on the type of corneal dystrophy.

·    Some individuals maintain good vision for many years.

·    Advanced disease may require surgical intervention to restore clarity.

·    Modern treatments have significantly improved outcomes.

Prevention:

·    There is no known method to prevent corneal dystrophy because it is genetic.

·    Regular eye examinations help detect progression early.

·    Family members may consider screening if there is a known history.

When Should I See My Healthcare Provider? Seek evaluation if you notice persistent blurred vision, light sensitivity, or recurrent eye pain.

When Should I Go to the Emergency Room? Go immediately if you experience sudden severe eye pain, rapid vision loss, or signs of infection.

What Questions Should I Ask My Healthcare Provider?

    ·    What type of corneal dystrophy do I have?

    ·    How often should I be monitored?

    ·    What treatment options are available?

    ·    Will I need surgery in the future?

    ·    How can my symptoms be managed effectively?

Key Takeaways:

    ·    Corneal dystrophy is a group of inherited corneal disorders.

    ·    Abnormal deposits accumulate in corneal layers.

    ·    Symptoms vary but may include blurred vision and recurrent erosions.

    ·    Management ranges from observation to surgical treatment.

    ·    Regular follow-up improves long-term outcomes.