Discover how scleral lenses can significantly improve vision and comfort for those with lattice corneal dystrophy. Schedule your fitting today!
Lattice corneal dystrophy, also known as classic lattice corneal dystrophy or Biber-Haab-Dimmer dystrophy, is a condition that not many have heard of, but for those affected, it can have a profound impact on their daily lives. A rare and hereditary eye disorder, lattice corneal dystrophy affects the clear, outer layer of the eyes, the cornea, and can potentially lead to vision impairment or loss. Understanding what causes lattice corneal dystrophy, its symptoms, types, and treatment options can provide clarity to those grappling with this condition.
Lattice corneal dystrophy typically appears during the first or second decade of life.
The cause of lattice corneal dystrophy can be traced back to genetics. It's a condition that's inherited in an autosomal dominant manner, which means a child only needs to receive the defective gene from one parent to potentially develop the disorder. This disease is characterized by the accumulation of abnormal protein fibers, known as amyloid, in the cornea, causing a progressive alteration of the corneal structure.
While there is no known cure for lattice corneal dystrophy, the condition can be managed and its impact on vision and comfort can be minimized.
Lattice corneal dystrophy can present several challenges, including persistent discomfort and vision distortion. However, an innovative treatment in the form of scleral lenses has emerged as a gold standard solution. Unlike typical contact lenses, scleral lenses have a larger diameter, enabling them to vault over the entire corneal surface, including any irregularities caused by the dystrophy.
These lenses function by creating a new, smooth, undamaged surface for light to pass through, vastly improving visual acuity. Additionally, scleral lenses form a pocket filled with saline solution between the lens and the cornea, helping to keep the eye moist and comfortable throughout the day.
Scleral lenses fitting is a meticulous process, particularly for those with lattice corneal dystrophy. To provide the best fit and maximum comfort, a comprehensive assessment of the eye's surface is performed. This procedure involves a detailed measurement of the cornea's shape and size and the evaluation of any corneal irregularities.
An accurate fitting is paramount for achieving the maximum potential benefits, including:
The main types of corneal transplants used for treating lattice corneal dystrophy (LCD) at advanced stages include penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK), and phototherapeutic keratectomy (PTK). PK is the preferred treatment option once visual symptoms progress to the point where surgical intervention is necessary. Transplant is not usually necessary before the fourth decade, although it may be required as early as the second decade of life. Recurrence of LCD is common after PK, with amyloid deposits forming in the grafted cornea years later. DALK, which retains the Descemet's membrane and endothelium, has similar outcomes to PK but may offer better visual outcomes and lower risks of graft rejection. PTK can be used to improve vision by resolving lattice changes, erosions, and opacifications. However, it is considered a second-line intervention and is unable to address deeper lesions. Each procedure carries its own risks, such as graft rejection, irregular astigmatism, and other complications.
The symptoms of lattice corneal dystrophy can vary widely among those affected, and they often first appear in childhood or adolescence. These can include:
Lattice corneal dystrophy is primarily a hereditary condition, meaning that those at highest risk are individuals who have a family history of the disorder. The disease is inherited in an autosomal dominant pattern. This means that a single copy of the altered gene in each cell is sufficient to cause the disorder. If one parent has the condition, there is a 50% chance that their child will inherit it.
It is important to note that both men and women can be equally affected by lattice corneal dystrophy. The disease does not discriminate based on sex, and it has been identified in populations all around the world, implying no racial or ethnic predisposition.
Though symptoms often first appear in childhood or adolescence, the onset and progression can greatly vary among individuals, even among those within the same family. Therefore, early detection through regular eye examinations is key, especially for those with a family history of lattice corneal dystrophy.
In some rare cases, lattice corneal dystrophy may occur in individuals without any known family history of the disorder. These cases are often the result of new mutations occurring in the gene responsible for the condition. Nonetheless, those individuals are then at risk of passing the mutation on to their offspring.
There are several types of lattice corneal dystrophy, but the two most common are types 1 and 2.
Type 1, also known as Biber-Haab-Dimmer dystrophy, primarily affects the eyes. Symptoms often appear in childhood, but the severity and progression of the disorder can vary greatly among individuals.
Type 2, or familial amyloidosis, is more severe and affects more parts of the body than just the eyes. Symptoms are usually systemic and can include kidney disease, heart disease, and nerve damage in addition to eye problems.
Understanding your insurance coverage is essential when considering treatments like scleral lenses. While each insurance policy differs, many do offer some form of coverage for scleral lenses, especially when they're medically necessary, as in cases of lattice corneal dystrophy. However, the exact coverage and out-of-pocket expenses may vary, depending on your insurance plan's specifics. We advise patients to speak directly to your eye doctor's office staff. They can provide guidance and help clarify any questions you may have about your insurance coverage and the potential costs associated with scleral lenses. Remember, the ultimate goal is to find a treatment that not only improves your vision but also aligns with your financial considerations.