Hornhautödem

Hornhautödem refers to swelling of the cornea, the transparent outer layer of the eye that covers the iris and pupil. This swelling occurs when excess fluid accumulates in the corneal stroma, the middle layer of the cornea. The normal cornea maintains a delicate balance of fluid, regulated by specialized cells called endothelial cells. When these cells are compromised or their function is impaired, they are unable to pump fluid out of the stroma effectively, leading to edema.

Symptoms of hornhautödem can vary depending on the severity and underlying cause. Mild swelling may cause blurred vision and a feeling of fullness in the eye. As the edema progresses, patients may experience more significant visual disturbances, such as halos around lights, starbursts, and a general haziness of vision. Pain, redness, and increased light sensitivity can also occur. In severe cases, the cornea may become opaque, leading to profound vision loss.

Several conditions can lead to hornhautödem. These include corneal dystrophies, such as Fuchs' endothelial dystrophy, which affect the function of the endothelial cells over time. Trauma to the eye, including surgical procedures like cataract surgery or corneal transplants, can also damage the endothelium. Certain eye infections or inflammatory conditions can also contribute to corneal swelling. Prolonged wear of contact lenses, particularly if worn improperly or for extended periods, is another common cause. Increased intraocular pressure (glaucoma) can also impede fluid outflow from the cornea.

Diagnosis of hornhautödem is typically made by an ophthalmologist during a comprehensive eye examination. Techniques like slit-lamp biomicroscopy can visualize corneal swelling and identify signs of endothelial dysfunction. Other diagnostic tools may include corneal topography and pachymetry to measure corneal thickness. Treatment strategies depend on the underlying cause and severity of the edema. Mild cases may be managed with topical hypertonic saline solutions to draw fluid out of the cornea. For more severe or persistent edema, surgical interventions, such as endothelial keratoplasty (corneal transplantation), may be necessary to replace the damaged endothelial cells.