Most people with Fuchs’ dystrophy start to have symptoms around age 50 to 60. This disease makes a type of cornea cells (called endothelial cells) stop working. When these cells stop working, the cornea swells and gets thicker. These cornea changes can cause vision problems.
Symptoms of Fuchs’ dystrophy include:
Blurry vision that’s worse in the morning and better later in the day
Glare and halos in your vision that make it hard to see things at night or in low light
Sensitivity to light
Treatments for Fuchs’ dystrophy include eye drops, ointments, and special contact lenses to help reduce corneal swelling. If your disease is more severe, you may need a corneal transplant.
Keratoconus is usually diagnosed in teens and young adults. It causes the middle and lower parts of the cornea to get thinner over time. While a normal cornea has a rounded shape, a cornea with keratoconus can bulge outward and become a cone shape. This different cornea shape can cause vision problems.
Symptoms of keratoconus include:
Nearsightedness (when far-away objects look blurry)
Astigmatism (when things look blurry or distorted)
Sensitivity to light
Most people with keratoconus can correct their vision problems by wearing glasses, soft contact lenses, or special hard contact lenses that change the shape of the cornea. Your doctor may also recommend a procedure called corneal cross-linking to strengthen your cornea. If your keratoconus causes severe corneal scarring or you have trouble wearing contact lenses, you may need a corneal transplant.
If you have severe damage to your cornea (the clear front layer of your eye), doctors can replace the damaged part with healthy corneal tissue from a donor. If you have scarring or other damage that affects the whole cornea, doctors can do a full thickness corneal transplant (called a penetrating keratoplasty). If only part of your cornea is damaged, doctors can do a partial thickness transplant (called a lamellar keratoplasty).
You may get general anesthesia to put you to sleep during the transplant surgery, or you may be awake. If you’re awake, your doctor will put medicine in your eye to make it numb and give you another medicine to help you relax. Your doctor will use a special tool to keep your eye open during surgery. They will remove the damaged part of your cornea and replace it with healthy donor tissue.
Corneal transplant is an outpatient surgery, so you can go home the same day. You won’t be able to drive, so you’ll need someone to give you a ride home after surgery. Depending on the type of transplant, it can take up to a year to fully recover. Talk with your doctor about when you can get back to your normal activities.
Epithelial basement membrane degeneration (EBMD), also known as "map-dot-fingerprint dystrophy," is a disease of the eye surface that may cause blurred vision and recurrent corneal erosions. Most patients with EBMD don't even know they have it, but patients with symptoms may benefit from a minor surgery to remove the diseased layer from the cornea.
Salzmann nodular degeneration (SND) is a progressive corneal disease that primarily affects middle-aged adults, especially women. Patients with SND form small bumps on the eye surface that can cause discomfort and distorted vision. Mild cases may benefit from artificial tears, but advanced cases may require surgical removal.
REFRACTIVE SURGERY (LASIK/PRK)
Some types of surgery can change the shape of your cornea (the clear front layer of your eye) to fix refractive errors. The most common type of refractive surgery is called LASIK (laser-assisted in situ keratomileusis). Most types of refractive surgery, including LASIK, use lasers to change the shape of the cornea. Some use other tools, like implants.
LASIK uses a laser (a strong beam of light) to change the shape of the cornea and help make vision clearer. It works best for adults with nearsightedness, farsightedness, or astigmatism. After LASIK, most people see well enough to stop wearing their eyeglasses or contact lenses for most of their daily activities.
LASIK isn’t right for everyone. Some eye conditions can raise your risk for complications from LASIK, including:
Keratoconus (a disease that makes the cornea thinner over time)
Eye infections, like keratitis or ocular herpes
Talk with your eye doctor to decide if LASIK or another type of refractive surgery is right for you.
Pterygium, also known as "surfer's eye," refers to an overgrowth of the pink skin layer of the eye (the conjunctiva) onto the clear surface of the eye (the cornea). Anyone can get a pterygium, but people who spend a lot of time in the sun are at higher risk.
Symptoms of pterygium include:
Foreign body sensation
At early stages, you may get symptomatic relief with artificial tears, and protection from the sun and wind. If the pterygium is causing severe symptoms, or is affecting the vision, then your doctor may recommend surgery to remove the pterygium.