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News » Corneal dystrophies: what exactly is it and how to intervene in their presence

Corneal dystrophies: what exactly is it and how to intervene in their presence

For corneal dystrophies is referred, in the medical field, those genetically based non-inflammatory disorders that lead to a secondary visual impairment and to corneal opacification.
They can be unilateral, if they affect only one eye, or bilateral, if the disorder involves them both. Their manifestation consists in the formation of haze in a clear or opaque cornea that causes the loss of the cornea and cause transparency, for the effect, a visual impairment.
The reduction of visual acuity varies because of their size, their depth and their localization.

Causes and types
Corneal dystrophies are caused by the mutation of certain genes, in part identified.
There are different types of dystrophies that vary based on the location.
Dystrophies can, in fact, hit the cornea in the various layers.

From the clinical point of view, they can be classified into:
• epithelial;
• Bowman\'s membrane;
• stromal;
• endothelial.
Between epithelial corneal dystrophies include the epithelial basement membrane dystrophy (Cogan\'s dystrophy) which generally occurs in adulthood, between 50 and 70 years.
It, according to statistics, seems to hit mainly the female sex.
The main alteration is given by a thickening of the epithelial basement membrane, which in part tends to intrude in the epithelium forming foils and similar fibrils to those of the membrane itself.
Even corneal dystrophy Meesmann falls between epithelial: it is characterized by the presence of wide corneal epithelial vesicles that cause photophobia, lacrimation, urge to close his eyes and in a slightly reduced vision persistent and enforced.
Another type of dystrophic lesion regards the Bowman\'s membrane, it is attributable to the presence of fibrillo-granular material that is deposited between the epithelial membrane and Bowman\'s layer.
The accumulation of this material prevents the migration of epithelial cells toward the surface causing cysts formed by degenerated cells.

From the point of view of the corneal dystrophies symptoms are distinguished:
- Lattice, characterized by amyloid deposits which are the cornea assume the appearance of a lattice;
- The "Avellino", characterized by opacity and reticular lesions stroma and stromal deposits;
- Macular corneal, characterized by an accumulation of collagen in the corneal lamellae level;
- Gelatinous drop, with deposits of amyloid substance in anterior stromal level which are due to the formation of nodules.

How to intervene in the presence of corneal dystrophy
If the form in which the corneal dystrophies occur is mild, if, in other words, involves alteration of the minimum vision, in general they do not care.
The treatment of these diseases, however, is absolutely required in the case of more severe corneal dystrophies, where for these have to be understood as those that cause a more or less intense opacity.
The most severe corneal dystrophies can be treated surgically, with methods of ablation or excision of the corneal tissue.
Routine care is generally entrusted to the use of tear substitutes.
In cases of strong reduction of vision, it may be necessary the execution of a cornea transplant.

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