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Bullous Keratopathy
Last reviewed: 23.04.2024
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[What causes bullous keratopathy?
Bullous keratopathy is caused by corneal edema due to the inability of the corneal endothelium to provide a normal hydrobalance. This is most often associated with Fuchs corneal endothelial dystrophy or corneal endothelial trauma. Damage to the corneal endothelium can occur during intraocular surgery (for example, with cataract removal) or after implantation of a low-quality intraocular lens or an incorrect lens arrangement. Fuchs' dystrophy causes a bilateral progressive loss of corneal endothelial cells, sometimes leading to bullous keratopathy at the age of 50-60 years.
Symptoms of bullous keratopathy
Subepithelial, fluid-filled blisters form on the surface of the cornea and in its stroma of protrusion, resulting in discomfort, decreased visual acuity, loss of contrast, the appearance of glare and photophobia. Some blisters are bursting, infection and ulceration of the cornea occurs. The main symptom of rupture is moderate or severe pain.
Bullae and edema of the stroma of the cornea can be seen when examined on a slit lamp.
Treatment of bullous keratopathy
Treatment of bullous keratopathy should be performed by an ophthalmologist and includes the use of dehydrating substances (eg, hypertonic saline solutions), intraocular pressure-lowering drugs and soft contact lenses for mild to moderate symptoms. Usually successful is corneal transplant.