Fuchs’ Dystrophy is a slowly progressive disease of the cornea that occurs when the innermost layer of cells, called the endothelium, prematurely weakens, making it less efficient in its “pumping activity” which is required to maintain transparency for clear vision. Sometimes we may observe Fuchs’ Dystrophy in people in their 30’s and 40’s, but most often does not compromise vision until people are in their 50’s or 60’s. Early in the course of Fuchs’ Dystrophy you may wake up with blurry vision that gets progressively clearer as the day passes. In its later phases, Fuchs’ Dystrophy is often associated with considerable pain as the epithelium blisters called “bullae.” Many patients with Fuchs’ Dystrophy that require surgery to restore vision may benefit from a technique called Descemet’s Stripping with Endothelial Keratoplasty (DSEK). This type of corneal transplant involves only the diseased portion of the cornea and is sutureless.
Map-Dot-Fingerprint Dystrophy is a corneal condition affecting the outermost layer of the cornea, called the epithelium. It is attached to an underlying basement membrane called Bowman’s Membrane. Sometimes the epithelial basement membrane develops abnormally making it difficult or impossible for the epithelium to adhere properly to the basement membrane. If the epithelium does not adhere properly, Recurrent Corneal Erosions will occur. Recurrent Corneal Erosions are painful and cause the corneal surface to become irregular resulting in intermittent blurry vision along with the discomfort and foreign body sensation. Map-Dot-Fingerprint Dystrophy is also known as Epithelial Basement Membrane Dystrophy because it is caused by a lack of the healthy formation of the Basement Membrane. It affects adults between the ages of 40-70 and can sometimes begin earlier. As the name implies, its appearance is of a map of gray areas accompanied by opaque dots and fingerprint like whirls or lines. The best treatment results can be achieved using Excimer Laser Phototherapeutic Keratectomy (PTK) to smooth the surface of the cornea.
Lattice Dystrophy occurs from the accumulation of abnormal protein fibers, or amyloid deposits in the middle cornea layer called the corneal stroma. If these deposits become dense enough they will become opaque and affect the corneal transparency so that vision is reduced. If these deposits occur under the outermost layer, the epithelium, they can cause recurrent erosions of the cornea, which can be painful and disturb the normal corneal curvature, effecting vision. In instances where there are recurrent corneal erosions and pain, the doctor may prescribe eye drops, ointments and occasionally an eye patch or bandage soft contact lens. Early Lattice Dystrophy seems to respond well to Excimer Laser Phototherapeutic Keratectomy (PTK) whereas more serious cases may require a corneal transplant.