The cornea is at the front of the eye; it allows light rays to enter the eye. It has three layers, the outer epithelium, a middle area called stroma, and an inner, delicate lining called the endothelium. The job of the endothelium is to prevent water inside the eyeball from moving into and swelling the other layers of the cornea. The cells of the endothelium pump water from the cornea back into the eye.
Problems occur when this doesn’t happen. If the endothelium isn’t working correctly, water moves into the cornea. This leads to swelling that clouds the cornea and blurs vision. The more the cornea swells, the more vision is blurred.
Eventually, water makes it to the outer layer, the epithelium, resulting in eye pain and more severe vision impairment. This swelling also changes the normal curvature of the eye, changing vision. A sight-limiting haze also develops.
We have a set number of endothelium cells. We don’t make anymore, and they decrease as we age. For most people, even a decreased number of cells is sufficient to maintain vision even in old age.
Fuchs’ Corneal Dystrophy
Fuchs’ Corneal Dystrophy is an inherited condition that affects the inner cornea, the endothelium. People with this condition have endothelial cells that aren’t as efficient as they should be in moving water, and they age and deteriorate more rapidly than normal endothelial cells. This allows more water to move from inside the eyeball into the cornea.
Hazy morning vision — This is because when our eyes are open during the day, water evaporates from the eye. But at night, with our eyelids closed, this doesn’t happen, so the patient wakes with hazy, blurred vision due to the water buildup at night.
These are other symptoms:
- Fluctuating vision
- Glare when looking at lights
- Light sensitivity
- Sandy, gritty sensation
- Episodes of sharp, sometimes incapacitating pain
At Central Valley Eye Medical Group, we can diagnose Fuchs’ Corneal Dystrophy and, although there is no cure, treat it. We prescribe salt solutions containing sodium chloride to draw fluid from the cornea to reduce swelling. Steroid eye drops are useful in some patients. We also give the patient some home practices, such as holding a hair dryer at arm’s length and blowing the air towards the face with the eyes open. This evaporates water from the cornea and temporarily reduces swelling.
When vision deteriorates to the extent that it interferes with daily activities and impairs the patient’s life, we may recommend a cornea transplant. This surgery replaces the full thickness of the cornea, all three layers, with healthy layers.