Benjamin C. Yanofsky, O.D., F.A.A.O., is a VSP eye doctor at Advanced Eyecare of Arizona. Dr. Yanofsky is an active member of the Mesa Rotary Club and the Mesa Chamber of Commerce. In his free time, he enjoys exploring the desert, hiking, swimming, and just relaxing with his wife and two children.
Corneal dystrophy is a degenerative eye disease caused by abnormal cellular function and development, leading to excess fluid in the cornea. The cornea is the part of the eye that covers your iris and pupil, forming the front-most part of your eyes. It is formed of crystal-clear protective layers and helps focus light passing onto the lens where vision “begins” in a sense. While corneal dystrophy can cause vision impairment, it rarely leads to complete blindness.
The cornea consists of six layers, and deterioration can start in any of them. This leads to swelling (edema) that interferes with normal vision. Think of it like a smudge on a camera’s lens. You probably won’t be able to see these distortions, but an eye doctor can find them during a comprehensive eye exam, specifically when using a slit lamp microscope.
There are a number of different kinds of corneal dystrophy that vary based on which layer of the cornea they affect and the cause of the deterioration. There are three main categories:
- Epithelial Dystrophy (affecting the outermost layer of the cornea)
- Stromal Dystrophy (affecting a middle layer of the cornea responsible for strength, structure, and flexibility)
- Endothelial Dystrophy (affecting the innermost layer of the cornea)
If you’ve heard the term “corneal dystrophy,” odds are that person was referring to endothelial dystrophy, specifically Fuch’s (pronounced Fooks) endothelial dystrophy. This particular type of corneal dystrophy was first discovered by an Austrian ophthalmologist named Ernst Fuchs in 1910. The endothelium is the layer that regulates the fluids in the cornea, as I mentioned above. When it malfunctions, the fluid starts to seep into the cornea and distort vision. Fuch’s corneal dystrophy most often appears in your 40s and affects women more often than men.
Many of the symptoms of corneal dystrophy, like blurry vision, halos around light, and difficulty seeing at night, overlap with symptoms of other common eye conditions, such as cataracts and glaucoma. That’s why the best diagnosis will be one from your eye doctor who can take a look at the actual problem areas rather than just assess symptoms.
Two symptoms that may differentiate corneal dystrophy from the early stages of glaucoma and cataracts are actual eye pain and feeling as if something is in your eye. The pain usually comes as a result of the blister-like changes that form on your cornea as corneal dystrophy progresses. They may disappear as the condition worsens, but the trade-off is that your vision becomes poorer. The feeling that something is in your eye is a result of the irregularities that are present in your cornea. These irregularities can lead to fluctuating vision, a thin tear film, and a swollen cornea.
The treatments for corneal dystrophy range from eye drops to a cornea transplant. In many instances, your eye doctor might prescribe special contacts that will act as a bandage for the outermost layer of your cornea until the tissue can repair itself. The progression of corneal dystrophy doesn’t have a reliable timeline; it can range from months to decades.
Corneal dystrophy is an inherited condition, which means prevention is a mystery. The good news is that this condition is treatable. There are a number of promising medications, topical and oral, that may offset the effects of corneal dystrophy. There are even custom-designed contact lenses that improve the quality of vision while helping the eyes to heal. Your VSP eye doctor can help you find the treatment that is right for you. A corneal transplant is conducted as an outpatient procedure under local anesthetic. Although recovery is relatively quick (a week or less), your vision could be inconsistent for as long as a year after the procedure.
If you feel you are experiencing symptoms of corneal dystrophy or would like to have an eye doctor examine your eyes for other conditions, schedule an exam with your VSP eye doctor.
The content of this article is for general informational awareness purposes only, and is not intended to be a substitute for professional advice, diagnosis, or treatment. Please consult your eyecare doctor or physician for actual advice, diagnosis, or treatment. This article is the work of the attributed author and does not necessarily represent the views or opinions of VSP. If you think you may have a medical emergency, call your doctor or 911 immediately.