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Corneal Dystrophy - Types, Symptoms, Diagnosis, and Treatment

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Corneal dystrophy is a genetic degeneration of the cornea. Read this article to know more.

Medically reviewed by

Dr. Rahul Vaswani

Published At January 18, 2023
Reviewed AtJune 19, 2023

What Is Corneal Dystrophy?

A corneal dystrophy is a group of conditions that affect the cornea. Corneal dystrophy may occur genetically. There are more than 20 such conditions that affect the cornea. Over the course of time, due to degeneration of the cornea, the vision becomes blurred or cloudy. Corneal dystrophy worsens over a period of time. It may take many years for the symptoms to show. Sometimes, the condition can be asymptomatic as well. Some of the common features of corneal dystrophy include the following:

  • Often, genetic predisposition and the condition may run in the family.

  • Mostly affects both eyes. However, the gradient of damage may vary.

  • Affects both sexes equally.

  • It may not affect other parts of the eyes.

What Are the Types of Corneal Dystrophy?

Corneal dystrophy is classified based on the layer of the affected cornea. The classification is as follows:

Anterior or Superficial Corneal Dystrophy: This type of dystrophy affects the two outer layers of the cornea. These types of corneal dystrophy develop under 20 years. The most widely recognized kind of this dystrophy is epithelial cellar film dystrophy or map-spot finger impression dystrophy. That is because, during an eye test, the primary care physician might see dabs, unique finger impression shapes, or ill-defined situations like a guide on the cornea. Many individuals with this illness usually do not have any symptoms. These may be known as the Bowman’s membrane and epithelium membrane. The diseases that come under this include:

  1. Lisch corneal dystrophy.

  2. Basement epithelial dystrophy.

  3. Meesmann epithelial dystrophy.

  4. Reis- buckler epithelial dystrophy.

  5. Thiel- Behnke epithelial dystrophy.

Stromal Corneal Dystrophy: This type of corneal dystrophy affects the stromal layer. The stromal layer is the middle layer of the cornea. This may also affect the other layers of the cornea. This type of degeneration starts before the teenage years. The side effect may be seen immediately for some people, whereas for others, it may take a while before the symptoms show. The types of stromal dystrophy may include:

  1. Granular corneal dystrophy.

  2. Lattice corneal dystrophy.

  3. Macular corneal dystrophy.

  4. Gelatinous drop-like corneal dystrophy.

  5. Schnyder crystalline corneal dystrophy.

Out of these varieties, lattice corneal degeneration is the most common. It is named after the lattice pattern of protein growth between the corneal layers. It most frequently occurs between the age group of two to seven years.

Posterior Corneal Dystrophy: This type of dystrophy affects the cornea's innermost layer, namely the Descemet’s membrane and endothelium layers. Most of this corneal degeneration is present even since birth. Posterior corneal dystrophy may include the following:

  1. Fuchs’ endothelial corneal dystrophy.

  2. Posterior polymorphous corneal dystrophy.

  3. Congenital hereditary endothelial dystrophy.

Fusch’s dystrophy is the most common degeneration in the posterior column. This type of degeneration occurs when a person hits middle age. However, the symptoms may take even longer to show. In this type of degeneration, the cells die due to excess fluid accumulation. This accumulated fluid can also cause clouding of vision.

What Are the Symptoms of Corneal Dystrophy?

The symptoms of corneal dystrophy depend on the layer of the cornea that may be affected. Usually, the symptoms take a while before showing up. Some types of corneal dystrophies may have no symptoms at all.

The symptoms of corneal dystrophy may include:

  1. Clouding of Vision: Clouding of vision is the most common symptom of corneal dystrophy. It can occur due to fluid accumulation in the corneal layers.

  2. Watering of Eyes: Corneal dystrophies may be associated with the watering of the eyes. This is frequently associated with corneal erosions.

  3. Dryness of the Eyes: Dry eyes could be one of the symptoms of corneal dystrophies.

  4. Photophobia: A person with corneal dystrophy can have sensitivity to light or photophobia as one of its symptoms. This can be due to fluid accumulation in the eyes.

  5. Eye Pain: There may be pain in the eyes associated with corneal dystrophy.

  6. Uneasiness in the eyes: There can be unease in the eyes. The person may feel a foreign body in the eye, which may cause unease.

  7. Corrosion of the Cornea: Corneal dystrophy can cause corrosion of the cornea. This can cause detachment of the corneal layers.

How to Diagnose Corneal Dystrophy?

The following can diagnose corneal dystrophy:

  • Analyzing Family History: Family history of corneal dystrophies can help analyze the inheritance pattern.

  • Routine Examination: A routine examination of the eye can itself help in identifying many corneal dystrophies.

  • Slit Lamp Microscope: Slit lamp test is performed by an ophthalmologist. In this test, a bright light is passed through the eyes. This helps in visualizing the layers of the eyes.

  • Genetic Analysis: Analysis of the genes of a person can help analyze any possibilities of corneal dystrophies.

How Is Corneal Dystrophy Treated?

  • Treatment for corneal dystrophy depends on factors such as

  1. The type of dystrophy.

  2. The effect of the condition.

  3. The layer of the cornea that is affected.

  • If corneal dystrophies do not have symptoms, the doctor will continuously monitor the eyes' condition.

  • Various treatment options, such as eye drops, ointments, or lasers, may be used if the condition progresses.

  • Corneal dystrophies are also associated with corneal erosions. This can be treated with the help of medications such as antibiotics, ointments, and lubricating eye drops. At times, soft lenses can also be used that protect the cornea. If erosion is continuously progressing, laser scraping is a procedure that can be used to treat it.

  • In severe cases of corneal dystrophy, a keratoplasty procedure can be performed. Keratoplasty is also known as a corneal transplant. A corneal transplant replaces the damaged cornea with a healthy donor cornea. A partial keratoplasty can also be performed depending on the severity of the condition.

Conclusion:

Corneal dystrophy is a genetic degeneration of the cornea. It is mainly caused due to genetic reasons. It may be present since birth or occurs gradually. Most of these conditions take a while before showing symptoms. Some of these conditions may be totally asymptomatic. The doctor may provide treatment according to the progression of the disease. Since this condition can go undiagnosed for quite some time, a regular eye checkup can help in diagnosing the condition at the earliest. Not only corneal dystrophy, but a regular eye examination can also help diagnose many other eye conditions. Thus a regular eye examination helps in diagnosing and preventing many eye conditions.

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Dr. Rahul Vaswani
Dr. Rahul Vaswani

Ophthalmology (Eye Care)

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