Corneal dystrophy is a set of hereditary diseases that cause clouding of the cornea and reduced visual acuity. In rare cases, acquired forms of corneal dystrophy occur. The cornea is the convex transparent part of the eyeball, which is located in the anterior region. It includes several layers: the protective layer of the epithelium, the second protective layer of the Bowman's membrane, a thick layer of tissues and fluids - the stroma, the posterior boundary layer - the Descemet's membrane, and the inner layer that removes excess water - the endothelium. Retinal dystrophy affects one of these layers. In a mild degree, this is expressed in the accumulation of certain tissues in the middle layers.
Types of diseases
The cornea is multilayered in its composition, and the types of dystrophies are divided according to the principle of affected layers:
- Epithelial.
- Stromal.
- Endothelial.
- Membranous dystrophy.
Primary
Besides this, dystrophysubdivided into primary and secondary. It is believed that the primary form of retinal dystrophy is congenital, that is, it is a genetic disease that affects both eyes. The congenital form of dystrophy is characterized by a slow course, and the patient discovers the first symptoms in himself only by the age of 30. Diagnosis is complicated by the genetic condition of the disease, so the primary form of dystrophy is detected only after genetic analysis.
Secondary
Secondary, also known as acquired retinal dystrophy, usually affects only one side. And it occurs as a result of various injuries, inflammations, surgical interventions and various disorders in the human immune system. Medicine has more than two dozen varieties of corneal dystrophies and combines them into three categories, due to which layers of the cornea are affected by the disease. Superficial retinal dystrophy extends only to the anterior layers - epithelial and Bowman's membrane. The disease, concentrated in the stroma, is included in the category of stromal retinal dystrophies. In the third category are deep layer dystrophies affecting the Descemet's membrane and endothelium.
Reasons
There are quite a few causes of corneal dystrophy, so it is not always possible to establish what was its catalyst. The main causes include, first of all, the hereditary factor, followed by pathologies of the immune system, post-traumatic neurotrophic changes, consequences of inflammation of the corneaor transactions performed. Secondary corneal dystrophies appear as a result of existing pathological processes.
For example, after burns of the sclera or conjunctiva, tear fluid deficiency, collagenosis, congenital glaucoma, eversion and inversion of the eyelids, with exacerbation of keratoconus, due to beriberi. Diabetic retinopathy often occurs in a patient with diabetes mellitus against the background of strong long-term changes in the body. Diabetes mellitus affects blood vessels, and small retinal vessels are no exception. The blood flow in the capillaries increases, after which it is completely clogged, neovascularization and hemorrhage occur. The vascular system of the retina is very fragile, any violation of its functions can become a catalyst for the development of corneal dystrophy. Dysfunctions of the immune system in many cases contribute to scarring of the stratum corneum. Wrong diet, diet or eating low-quality foods causes dystrophy. Systematic smoking and drinking alcohol-containing drinks adversely affect the retina of the eye and can become one of the factors in the development of corneal dystrophy. If the patient suffered severe viral diseases, but did not cure them to the end, then these diseases or their consequences will cause retinal dystrophy. The same applies to chronic cardiovascular diseases and pathologies of the endocrine system. Progressive diabetes mellitus, dysfunction of the circulatory system, metabolic disorders, especially in the presence of excess weight, form a serious risk factor for the patient.
Symptoms
The first signs of epithelial dystrophy of the cornea of the eye can begin as early as 10 years old, as a rule, the disease does not occur later than forty-five years of age. Retinal dystrophy is a group of diseases, but their symptoms appear in a single set of signs. Basic symptoms of corneal dystrophy include:
- methodical deterioration in visual acuity;
- clouding and swelling of the cornea;
- mucosal hyperemia;
- involuntary release of tear fluid;
- photophobia;
- soreness;
- Sensation of a foreign body in the eye.
Main feature
A pronounced sign of stromal corneal dystrophy is a significant deterioration in vision in the morning with a gradual improvement towards the end of the day. During the night, moisture accumulates in the corneal tissues, it begins to slowly dry out after a person gets up and vision returns to normal.
Diagnosis
If you suspect corneal dystrophy, you should consult an ophthalmologist. The he althcare professional should examine the patient using an ophthalmic slit lamp. In addition to the study using a slit lamp, to make a correct diagnosis, the patient is invited to undergo a full examination. It necessarily includes: perimetry and visometry, measurement of fluid pressure inside the eye, assessment of the structure of the eye using ultrasound, examination of the conjuncture of the nerve cells of the eye, examination of the fundus, biomicroscopy, laboratory analysis of corneal infiltrate, OCT.
How to treat corneal dystrophy?
Methods of treatment of all corneal dystrophies are the same, despite the different types of disease. Usually, treatment includes drugs to restore the epithelium, eye drops and ointments. Eye drops and ointments have a positive effect in tissue repair, create a protective barrier, relieve swelling and moisturize the surface of the cornea. For the treatment of retinal dystrophy, such remedies as Solcoseryl, VitA-Pos, Actovegin, Korneregel, vitamins and enzymes are suitable.
With a confirmed diagnosis of retinal dystrophy, it is important to strengthen and expand the small vessels inside the eye. Angioprotectors and vascular smooth muscle relaxers help with this, this group includes Complamin, Papaverine, No-shpa. Drugs that prevent the occurrence of clogging blood clots in the vessels - antiplatelet agents, are often prescribed for such eye pathologies. The doctor may apply "Clopidogrel" or "Ticlopidine". The drug "Lucentis" inhibits the growth of newly formed vessels, and "Pentoxifylline" levels the microcirculation of blood and lymph in the retina. For the treatment of dystrophies, the drops "Oftan-Katahrom", "Taufon", "Emoxipin", "Balarpan" are best suited. They actively favor the harmonization of metabolic processes and tissue repair. In case of inflammation of the cornea, additionallyantibacterial drugs "Levomitsetin", "Tobrex", "Floksal" are prescribed. If necessary, contact lenses are selected to help restore the epithelium. All of the above methods of treatment are more suitable for the initial stage of the disease.
Physiotherapy
Physiotherapy methods – electrophoresis and laser irradiation – are widely used in the treatment of corneal dystrophy. But physiotherapy is not able to prevent the destructive process of the disease. Physiotherapy is designed to stop the pathological process and preserve the patient's vision.
In the vast majority of cases of corneal dystrophy, one cannot do without an operation that is selected individually. Laser coagulation of the retina, vasoreconstruction, revascularization, vitrectomy or keratoplasty are performed. The last operation is aimed at removing the affected area of the cornea. A donor graft is placed in place of the removed site. As a rule, after the operation, the patient's condition improves rapidly and the disease almost never recurs. In rare cases, the patient has to undergo such an operation again.
Folk methods
In the initial stages of corneal dystrophy, in combination with the main treatment, traditional medicine is able to deal with the symptoms of the disease. Many patients are helped by hirudotherapy, which will improve the functioning of the immune system, lower blood sugar levels, relieve inflammation and remove from the bloodharmful substances. Alternative medicine offers a wide range of prescriptions for the treatment of corneal dystrophy. Reviews are positive. For example, if there is a threat of retinal detachment, it is recommended to drip a mixture of goat's milk and boiled water into the eyes in a ratio of one to one. Good eye drops are obtained from a decoction of celandine and a mixture of decoctions of cumin and cornflower. Herbs are not only used as useful drops, but are often taken orally, for example, infusions from birch leaves and lingonberries. Treatment of corneal dystrophy with folk remedies is quite effective. But it should be carried out only under the supervision of a specialist.
Preventive measures
There are no special procedures to prevent corneal dystrophy. If the patient has a genetic predisposition to this disease or other eye pathologies, then even if there are no problems, you should visit an ophthalmologist. People with an established diagnosis of retinal dystrophy, in order to avoid relapses, should undergo a preventive examination twice a year. It is also necessary to protect your eyes from contact with ultraviolet rays, that is, as often as possible, wear glasses with tinted lenses. It is forbidden to expose the eyes to overexertion, while working at a computer or reading, it is necessary to take breaks. Corneal dystrophy, left without proper treatment, ultimately leads a person to complete blindness and subsequent disability. Retinal dystrophies have a favorable prognosis if the patient seeks help in a timely mannerand performs all the procedures prescribed by the doctor. If such diseases were not observed, then preventive measures will be general. That is, observing the correct sleep and rest regimen, a balanced diet.
