The cornea of the eye is the outer anterior membrane, designed to perform a protective, light-guiding, refractive and moisture-producing function. The cornea is more prone to injury than other parts of the eye, which can lead to dystrophy.
What is dystrophy: forms of dystrophy
Corneal dystrophy includes a wide range of diseases, which leads to clouding of the anterior outer membrane of the eye. Depending on which layer of the cornea is affected (and there are five in total), several forms of the disease are distinguished:
- epithelial form of dystrophy, is the inability of epithelial cells to protect or in insufficient numbers;
- membrane dystrophy, which provokes improper synthesis of corneal proteins;
- stromal forms of dystrophy, arise due to changes in the composition of the stroma;
- endothelial forms of dystrophy is Fuchs dystrophy.
Causes of Dystrophy
The root cause of dystrophy lies in the damage to specific genes. Only narrowly targeted analysis will help localize the violations, after which you can talk about the primary or secondary form of dystrophy.
Primary dystrophies are hereditary. This disease is bilateral. Development occurs in childhood or adolescence, is not accompanied by inflammatory processes. The sensitivity of the organ decreases slowly, most often unnoticed by the patient.
Secondary dystrophies occur as a result of eye injuries, after surgery, inflammatory or autoimmune diseases.
Endothelial form of the disease
Endothelial disease, called Fuchs dystrophy, refers to the primary, genetic types of the disease. Let's talk about it in more detail.
What is Fuchs dystrophy? It damages the inner layer of the cornea, which acts as a pump, pumping fluid out of its thickness. Excess fluid in the cornea leads to clouding. Progressing, Fuchs dystrophy leads to a phased death of endothelial cells.
Over a period of time, the lack of cells is replaced by increased work of the remaining ones. Patients with an early stage of the disease notice a temporary visual impairment in the morning. This is due to the impossibility of vaporization of moisture from the surface of the cornea at night, which leads to its accumulation. Open eyelids allow moisture to evaporate naturally, as a result of which normalization of the state is observed throughout the day. And since endothelial cells cannot be restored, they gradually die, therefore, vision remains low. With a critically rapid decrease in vision, a corneal transplant operation may be prescribed.
Symptoms of endothelial dystrophy
The clinical manifestations of Fuchs dystrophy can be expressed in different ways: from an asymptomatic course to severe pains and visible erosion.
In the initial stages, there is:
- blurry vision, which will improve during the day;
- light when looking at a light source;
- a feeling of the presence of a foreign body in the eyes.
Progressive pathology has such manifestations:
- cuts and redness of the mucosa;
- photophobia;
- hypersensitivity to light;
- swelling of the outer shell of the eye.
Edematous corneal dystrophy: Fuchs dystrophy
Epithelial-endothelial dystrophy can be both primary and secondary. Its secondary appearance occurs as a result of trauma or after surgery. The disease develops in one eye. Fuchs bullous dystrophy has a pronounced root cause in the form of domestic, industrial or surgical injury. And the main difference from primary edematous dystrophy lies in a limited area of the occurrence of edema, around which there are healthy cells capable of replacing defective cells. The onset of the disease is characterized by slight turbidity in the deep layers of the cornea and slight edema. The progression of the disease leads to an increase in the degree and extent of turbidity, to the appearance of bumps and small vesicles on the cornea. There is an increase in photophobia and pain.
Diagnosis of the disease
Fuchs endothelial dystrophy is diagnosed by an ophthalmologist. During the appointment, the doctor not only examines the cornea with a slit lamp, but also collects a medical history. In addition, ultrasonic pachymetry can be used, which will show the thickness of the cornea and help assess the degree of edema.
Endothelial microscopy allows you to count the number of endothelial cells per square millimeter of area.
Dystrophy treatment
The initial stages of the disease involve traditional treatment using drops and eye ointments, which help eliminate fluid from the cornea. But conservative treatment only slows down the process of corneal destruction. Recovery can only be guaranteed by surgery. In epithelial or membrane disorders, laser removal of the pathogenic region is used. Damage to deeper layers is fraught with corneal transplantation. Sometimes complete central removal of the cornea is necessary. The transparency of the cornea after surgical procedures is restored, the symptoms go away. But sometimes Fuchs dystrophy can again manifest itself after several years, which will lead to reoperation.
Preventative measures
It is easier to help patients who seek medical help in the early stages of the disease. The complex of their preventive measures should include a good diet, since the nutrition of corneal cells directly depends on what the patient eats. Food should be nutritious and balanced with vegetables and fruits included. Naturally, all kinds of injuries should be avoided and a doctor should be consulted if the first unpleasant sensations occur in the eye.
The duration of a patient’s sleep with a predisposition to the disease should be at least eight hours, which will allow the body to rest well and fully, and this, in turn, will prevent the appearance of problems with the cornea of the eye. When dystrophy is detected, contact lenses should not be worn, which can worsen the situation.
Both hereditary factors and injuries, injuries or diseases in the organ of vision can lead to dystrophy of the cornea of the eye . Timely seeking medical help and periodic preventive examinations will help not to aggravate the situation and significantly improve the condition of the diseased organ.