Corneal edema is the swelling of the cornea. Corneal edema is caused by fluid buildup, and it is a serious condition. It can have a number of causes, including disease, injury, or even certain drugs.
If left untreated it can lead to cloudy, and obscured vision.
What Are The Symptoms Of Corneal Edema?
The most common symptom of corneal edema is cloudy or blurred vision. If you notice that your vision is hazy when you wake up, but gets better as the day goes on, this may be an indication of edema.
Other symptoms you may notice:
- Eye pain, or discomfort, like there’s something in your eye
- Haloes around lights
What Causes Corneal Edema?
The cornea is made up of layers, and one layer, the endothelium, helps remove fluid that collects within the cornea. If these cells are damaged so they can’t remove fluid, the fluid builds up, causing the cornea to swell.
Endothelial cells do not regenerate, so if they become damaged there is permanent endothelial cell loss.
The most common causes of endothelial cell loss and corneal edema include:
- Fuchs’ Corneal Dystrophy
- Viral infections of the cornea
- Previous eye surgery such as cataract surgery, glaucoma surgery, or retina surgery
While corneal edema after cataract surgery is becoming less common due to advancements in surgical technology, when it does occur from cataract surgery, it is called pseudophakic corneal edema or pseudophakic bullous keratopathy.
Certain drugs can increase the risk of corneal edema. These include benzalkonium chloride (a preservative in eye drops and other drugs), chlorhexidine, a skin disinfectant, and amantadine (Gocovri), an antiviral and treatment for Parkinson’s.
What Are The Treatments For Corneal Edema?
Since the endothelial cells do not regenerate, the treatment for corneal edema is to replace the damaged cells. However, for mild corneal edema salt water eye drops (Muro 128) can be used three to four times a day to reduce the swelling. Muro 128 does not address the underlying problem of damaged endothelial cells but can be helpful for people with very mild corneal edema. A partial thickness cornea transplant is performed to replace the damaged cells and is curative for corneal edema.
The procedures known as Descemet’s membrane endothelial keratoplasty (DMEK) or Descemet’s Stripping Endothelial Keratoplasty (DSEK) are less invasive than full thickness corneal transplants because they only address the small area of the cornea that is damaged, leaving the healthy layers untouched. These are outpatient procedures performed with local anesthetic and IV sedation.
A small incision is made near the edge of your cornea. Through the incision, the Descemet’s membrane and the damaged endothelium are removed and replaced with new tissue. A gas bubble is put under the graft tissue to hold it in place, and the incision is sutured. The graft is monitored, and if necessary, a second bubble may need to be inserted to keep the graft in place until it bonds properly.
After the graft heals, the patient can be fitted with glasses or contact lenses in a few months after the surgery.
If you suspect you may have corneal edema, please schedule an examination immediately. Our corneal experts will evaluate your condition and develop a custom treatment plan. For an appointment, call (865) 584-0905.
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