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Corneal Dystrophy

Corneal dystrophy (CD) is the breakdown of the cornea due to deposits of molecules of the body. CD is a broad term that describes numerous genetic disorders that cause an equally numerous range of corneal dystrophies. They are categorized by where the deposits occur in the cornea. Each subcategory contains multiple genetic disorders. The deposits, or cysts, are made up of lipids or cholesterol.

The cornea is the clear layer of your eye that covers the lens and pupil. The outermost layer of the cornea is a thin layer called the epithelium, which is integral to refracting light into the eye. The first type of dystrophies takes place here; they are called epithelial dystrophies. The deposits can appear as dot-like cysts, irregular lines, fingerprint patterns, bands, or whirlpool shape.

Gelatinous drop-like corneal dystrophy is a type of epithelial dystrophy that looks different than the rest. It manifests as a gel-like blob in the cornea of the eye. This is very rare, but causes severe vision loss. On the other hand, epithelial basement membrane dystrophy is the most common case of CD. All of these dystrophies cause damage by keeping the epithelial cells from shedding.

Besides for the gelatinous dystrophy, most epithelial dystrophies are mild and symptoms can be treated efficiently. Most patients experience sensitivity to light and excessive tearing. In more extreme cases, they may experience pain. Untreated dystrophies can lead to vision loss. A corneal transplant or laser surgery may be needed.

The next type is stromal dystrophy. The stroma is connective and supportive tissue in the cornea. Deposits are normally grain-like and form a clear film. Depending on the disease, symptoms may not exist or be very severe. Vision loss is most common, but patients also report sensitivity to light and the feeling of something in your eye. The most severe case is macular corneal dystrophy, which can cause blindness and fits of pain. Glaucoma is also a possible outcome. A corneal transplant is often needed.

The final category is endothelial dystrophies. The endothelium is a layer of lymphatic and blood vessels. Fuchs’ dystrophy is the most common endothelial condition.  A build up of fluid in the cornea characterizes endothelial dystrophy. The only true symptom is blurred vision, which is normally worse upon waking.

As stated above, CD is caused by a genetic defect. They cannot be caused by any sort of infection or injury. Some can be present at birth, but most begin symptoms in early childhood and progress slowly through adulthood. The symptoms are nearly always bilateral. CD does not affect any other part of the body or one’s overall health, but can spread to other layers of the cornea.

In the earlier stages of the disease, pressure-reducing eye drops are used to reduce the chances of glaucoma. Laser eye surgery is normally very successful. A corneal transplant is normally a last resort but is needed for most advance cases of CD.