Corneal dystrophies are inherited conditions in which abnormal material builds up in different layers of the cornea, often in both eyes. They are typically bilateral, slowly progressive, and not caused by infection or inflammation.
By Layer Affected
Different dystrophies primarily affect the epithelium, stroma, or endothelium. For example, epithelial basement membrane dystrophy mainly involves the surface, while lattice and granular dystrophies affect the stroma, and Fuchs endothelial dystrophy targets the innermost layer.
- Epithelial dystrophies can cause recurrent erosions and surface irregularity
- Stromal dystrophies create cloudy deposits that reduce transparency
- Endothelial dystrophies lead to corneal swelling and blurred vision
- Many have characteristic patterns on slit-lamp examination
Clinical Implications
Symptoms range from mild discomfort to significant visual loss depending on the type and severity. Management may include lubricants, therapeutic contact lenses, laser treatment, or corneal transplantation in advanced cases.
- Family history and genetic testing can help confirm diagnosis
- Some dystrophies recur in grafts and need long-term follow-up
- Regular monitoring tracks progression and guides timing of treatment
- Protecting the ocular surface helps reduce erosions and pain
