Sight is one of our primary senses, so any condition that can negatively impact the eyes is an important one. So it goes without saying that understanding the nuances of corneal endothelial dystrophy, including its causes and treatments, is a key step to protect your eyesight.
Awareness is especially important for those individuals who are at an advanced risk of developing the condition. Learn more about the condition and treatment, and you could potentially save your eyesight.
What Is Corneal Endothelial Dystrophy?
Corneal dystrophy is a term used to categorize a group of genetic eye conditions that involves the accumulation of foreign material in the transparent outer layer of the eye, or the cornea. These disorders are further categorized depending on the particularly cells affected in the cornea.
Corneal Endothelial Dystrophy is one such classification. This form of the disease affects a thin layer of cells that are located along the back of the cornea. These cells are known as corneal endothelial cells and typically regulate the fluid level in the cornea itself. The job of these cells is particularly important because an appropriate balance of fluid in the cornea is essential for your vision to be clear.
As a group of genetic disorders, corneal dystrophies do often share characteristics. For example, most forms develop in both eyes and have a slow advancement. They typically are passed through families but affect no other parts of the body. And, in most cases, the disorders are inherited as dominant traits. It is important, however, to understand the specific characteristics and traits of endothelial dystrophy and to be aware of your level of risk.
Symptoms of Endothelial Dystrophy
As this form of dystrophy slowly causes an imbalance in the fluid in the cornea, it also creates swelling and inflammation in the front corner of the eye. As the swelling develops, you may experience a glare, cloudy or blurred vision, and discomfort.
The condition typically affects both eyes and gradually worsens over time. As such, most individuals with the condition do not experience any symptoms of the condition until they are in their 50s or 60s.
With progression in the disease, symptoms are likely to progress, causing:
- Light sensitivity and glare.
- Pain or discomfort in the eye.
- Blurred or foggy vision.
- Poor nighttime vision.
- Unusual changes in eyesight, such as seeing colored halos encircling lights.
- Poor vision early in the day that improves later.
- The sensation that something, such as grit or sand, is in the eye.
If you experience any of these symptoms, and particularly if they begin to worsen with time, you should see your eye doctor. He or she can refer you to a corneal specialist for further evaluation. In the event that you develop symptoms suddenly, contact your doctor for an urgent appointment. Eye conditions that often mimic corneal endothelial dystrophy also need treated promptly.
Causes of Corneal Endothelial Dystrophy
In a healthy, normally functioning cornea, the endothelial cells function to regulate the balance of fluid within the cornea. This present swelling and other complications. However, if you have endothelial dystrophy, your endothelial cells die off over time. The result of this lack in endothelial swells is a buildup of fluid or edema within the eye. The fluid buildup causes the characteristic thickening of the cornea as well as blurred vision.
The condition is most often passed on as a dominant autosomal trait. The process of genetic heritance is complex; some members of the family may not be impacted by the condition at all while others experience debilitating effects. It is also important to note that you can develop the condition with no family history of the disease.
Certain factors put you at more risk for developing the disease. These include:
- Sex – More women than men develop the condition.
- Genetics – A family history of the disorder puts you at a higher risk.
- Age – The condition rarely appears in childhood but typically starts in the mid- to late-20s and 30s. It is not typically until the 50s and 60s that individuals begin developing significant symptoms, though.
A history of smoking and diabetes may also contribute to your risk level for the disease.
Corneal Endothelial Dystrophy Treatment
The path of treatment for individuals with the disease varies depending on the degree of their disease. If no corneal decompensation has started, no medical treatment is typically necessary. However, once significant symptoms begin to develop, treatment should commence and may include one of several options.
An agent, such as sodium chloride may be used to dehydrate the cornea and pull out any buildup of fluid. This treatment is typically a 5% solution that is administered 4 to 6 times throughout the day.
Glycerin may also be used, but it is typically for diagnostic purposes. This agent causes rapid dehydration of the cornea and significantly improves vision. Some patients are able to use it as an ongoing treatment, but most find it too uncomfortable.
Warm air evaporation is another method used by some individuals to dry the cornea and improve vision. This treatment is typically achieved by holding a hair dryer at an arm’s distance and blowing the air over the cornea for 5-10 minutes. Evaporation is typically most effective first thing in the morning.
Reducing the pressure in the eye provides relief if eye pressure is one of the symptoms associated with your condition. This method is sometimes helpful even when the pressure is normal, particularly in instances when decompensation is borderline.
Drops, such as diclofenac 0.1%, may be used to treat symptoms, such as burning, itching, or discomfort. But the treatment may reduce the ability for the epithelial to heal and cause increased corneal melting.
If other treatments have become ineffective, surgery may be necessary. The options typically involve penetrating keratoplasty with or without cataract surgery, depending on the current state of your eyes. Your doctor will discuss specific options with you and help you determine which is right for you.
Corneal endothelial dystrophy is a progressive disease that can significantly affect your eyesight. It develops in the cornea as the endothelial cells lining the back of the cornea are unable to adequately regulate fluid. Symptoms don’t often develop until the late 50s or 60s and may include discomfort, blurred vision, and glare among others.
The disorder is typically treatable and since onset is generally slow, most individuals can get a good handle on the condition before significant damage is done.