👁️ Corneal decompensation happens when the endothelium (the inner layer of the cornea) fails to pump out fluid, causing corneal swelling (edema), cloudiness, and blurry vision.
- Causes:
- Fuchs’ endothelial dystrophy (most common)
- Trauma (surgical or accidental)
- Long-term contact lens wear
- Glaucoma or high eye pressure
- Inflammation or infection
- Symptoms:
- Hazy or blurry vision (often worse in the morning)
- Glare and light sensitivity
- Eye discomfort or pain in advanced cases
- Halos around lights
- Stages:
- Early: Mild swelling, subtle visual changes
- Moderate: Noticeable edema, thickened cornea
- Advanced: Bullae formation (epithelial blisters), pain, and risk of infection
- Treatment:
- Mild: Hypertonic saline drops/ointment to draw out fluid
- Moderate: Reducing contributing factors (e.g., pressure control in glaucoma)
- Severe: Endothelial keratoplasty (DSEK, DSAEK, or DMEK) — partial corneal transplant replacing only the damaged endothelial layer