Corneal Dystrophy & Keratoconus Portland, Maine

Fuchs’ Dystrophy
Fuchs’ Endothelial Dystrophy is a slowly progressive disease of the cornea that is generally found in both eyes and is slightly more common in women than men. While it is possible to observe Fuchs’ Dystrophy in people in their 30’s and 40’s, it usually does not compromise vision until people are in their 50’s or 60’s. The innermost layer of cells in the cornea, called the endothelium, is a single layer of non-regenerating cells. The endothelial cells are responsible for pumping water out of the cornea and helping to maintain the corneal transparency and thickness. While the reason is poorly understood, in Fuchs’ Dystrophy, the endothelial cells die prematurely. In the early stages, patients often notice increased glare especially when driving at night. Later in the condition, the cornea becomes swollen and cloudy which leads to blurred vision. In its most advanced stage, Fuchs’ Dystrophy is associated with episodes of eye pain as the epithelium “blisters” by forming “bullae”, which actually begin to burst open.

Early in the course of Fuchs’ Dystrophy patients will wake up with blurry vision that gets progressively clearer as the day passes. This phenomenon occurs because the cornea normally takes on water and swells during sleep. In Fuchs’ Dystrophy, the endothelium removes fluid from the cornea less efficiently and is unable to keep the cornea clear and compact overnight. Over time, if Fuchs’ Dystrophy worsens and the vision does not clear, Dr. Sise will attempt to reduce the corneal swelling with eye drops and ointments. If these measures fail to provide comfort and clear vision, it may be necessary to have a Corneal Transplant.

For some patients those patients requiring surgery, a newer procedure known as DSEK (Descemet’s Stripping Endothelial Keratoplasty) can safely restore vision. Dr. Sise can perform this procedure, which is a type of transplant, to help certain Fuchs’ Dystrophy patients overcome their discomfort and vision loss.

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Map-Dot-Fingerprint Dystrophy or Anterior Basement Membrane Dystrophy
The outermost layer of the cornea, called the epithelium, is attached or anchored to an underlying basement membrane. In some individuals, the epithelial basement membrane develops abnormally making it difficult or impossible for the epithelium to adhere properly to the basement membrane. This can result in blurry vision and a syndrome known as Recurrent Corneal Erosions. Recurrent Corneal Erosions can be painful and cause the corneal surface to become irregular. This will lead to intermittent blurry vision along with the discomfort and foreign body sensation. It usually affects adults between the ages of 40-70 but can often begin earlier. Its appearance is subtle and can be easily overlooked during routine eye examination. As the name implies, the condition is diagnosed by the appearance of opaque dots, and fingerprint like whorls or lines in the outermost cornea.

Dr. Sise will often discover Map-Dot-Fingerprint Dystrophy during a routine eye examination in patients who do not have any noticeable symptoms. In this case, treatment is not usually required. For symptomatic patients, Dr. Sise may prescribe lubricating eye drops, patch the eye, or apply a soft bandage contact lens. In more severe cases, a procedure to polish the cornea can restore a normal surface.

Lattice Dystrophy
Lattice Dystrophy occurs as a result of the accumulation of abnormal protein, or amyloid deposits in the middle cornea layer called the corneal stroma. If these deposits become dense they will appear opacify and affect the corneal transparency so that vision is reduced. The deposits can cause recurrent erosions of the cornea, which can be painful, and cause blurred vision. In instances where there are recurrent corneal erosions and pain, Dr. Sise may prescribe eye drops, ointments and occasionally an eye patch or bandage soft contact lens. Early Lattice Dystrophy seems to respond well to Excimer Laser Phototherapeutic Keratectomy (PTK) whereas more serious cases may require a Corneal Transplant.

Keratoconus is the most common corneal dystrophy found in the in the United States. It is characterized by a progressive thinning and distortion of the cornea.Keratoconus example The cornea begins to bulge outward causing nearsightedness and astigmatism. In more advanced cases the cornea becomes cone shaped and vision is affected. Keratoconus usually affects both eyes. In many cases it may be possible to improve the vision with special contact lenses. Unfortunately, for about 20% of patients, contact lenses do not work well and a corneal transplant may be necessary. A new treatment for Keratoconus known as Collagen Crosslinking is currently under investigation in the United States. Dr. Sise is the principal investigator at Eyecare Medical Group for a multi-center trial that is currently recruiting patients.

If Collagen Crosslinking or a Corneal Transplant should be considered for your Keratoconus, Dr. Sise will take all the time necessary to explain the risks, benefits and likelihood of success in your particular situation. Please be assured that all of your questions will be answered so that you can make an educated and informed decision about your treatment options at Eyecare Medical Group.

If you or a family member or friend needs information or an appointment regarding a Corneal Dystrophy including Fuchs Dystrophy, Lattice Dystrophy or Map-Dot-Fingerprint Dystrophy or Keratoconus, please take a moment to call Eyecare Medical Group in Portland, Maine
at 888-374-2020.

Eyecare Medical Group Cornea Specialists offer eye exams for all types of Corneal Dystrophy including Fuchs Dystrophy, Lattice Dystrophy or Map-Dot-Fingerprint Dystrophy and Keratoconus in Maine. We are conveniently located for patients from Auburn, Augusta, Bangor, Bath, Berwick, Biddeford, Bridgton, Brunswick, Cape Neddick, Casco Bay, Cumberland Center, Eliot, Freeport, Gardiner, Kennebunk, Kennebunkport, Kittery, Lewiston, Old Orchard Beach, Portland, Sanford, Scarborough, South Portland, Springvale, Topsham, Waterville, Westbrook, Winslow, Wiscasset, Yarmouth, Portland, Skowhegan and York Maine.

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