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Understanding Granular Corneal Dystrophy: The Essential Guide

According to a rough conservative estimate, out of every 1 million people in the United States, around 897 have some form of corneal dystrophy, including granular corneal dystrophy. Given the U.S population is about 334 million, this would mean approximately 150,000 people in the country are affected by corneal dystrophy.

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Understanding Granular Corneal Dystrophy: The Essential Guide Optometrist

What is Granular Corneal Dystrophy (GCD)?

Granular corneal dystrophy is a rare genetic disorder affecting the cornea, the transparent outer layer of the eye. It is characterized by the formation of small, sand-like opacities in the cornea that impair vision. These opacities typically progress over time, causing visual impairment that could significantly impact a persons quality of life.

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Granular Corneal Dystrophy Treatment: A New Horizon with Scleral Lenses

Scleral lenses are considered the gold standard of treatment for patients with corneal irregularities, including Granular Corneal Dystrophy. Unlike regular contact lenses, scleral lenses vault over the damaged ocular surface and create a new, smooth, undamaged surface. This technology dramatically improves vision by correcting the irregularities caused by the granular deposits in GCD.

Additionally, scleral lenses create a pocket filled with saline, keeping the eyes moist and comfortable all day long. This alleviates symptoms like dryness and discomfort, further enhancing the quality of life for those affected by granular corneal dystrophy.

It's important to note that while scleral lenses do not cure granular corneal dystrophy, they offer a non-invasive, highly effective method of managing the symptoms and improving vision quality.

Treatment Options for Granular Corneal Dystrophy

Treatment Options for Granular Corneal Dystrophy

In many scenarios, additional treatments may be recommended alongside the use of scleral lenses. 

For non severe recurrent corneal erosions (RCEs) associated with granular corneal dystrophy, bandage soft contact lenses coupled with antibiotic drops or antibiotic ointment may be utilized.

Further prevention of RCEs can potentially be achieved by implementing a regimen of sodium chloride drops or artificial tear lubricating drops during the day, accompanied by the application of lubricating ointment during the night.

In instances where RCEs continue despite these preventative measures, surgical interventions may come into play. Procedures such as corneal punctures, involving needle punctures to facilitate the adhesion of eye tissue to corneal cells, could be suggested. Another option is Phototherapeutic Keratectomy (PTK), a laser treatment aimed at eradicating corneal deposits and promoting the binding of eye tissue to the top layer of corneal cells.

Treatment Options for Granular Corneal Dystrophy

Treatment Options for Granular Corneal Dystrophy

Granular corneal dystrophy is caused by mutations in the TGFBI gene, which instructs the body to make a protein that interacts with other proteins in the cornea. This interaction is crucial for maintaining the transparency and integrity of the cornea. Mutations in the TGFBI gene lead to an abnormal protein, which accumulates as granules in the cornea, thereby causing GCD.

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Symptoms of Granular Corneal Dystrophy

Symptoms of Granular Corneal Dystrophy

Identifying the symptoms of granular corneal dystrophy early is paramount for effectively managing this condition and limiting its impact on your daily life. These symptoms can range from mild visual disturbances to significant discomfort. Here are the signs you should look out for:

  • Blurry or Cloudy Vision: One of the first and most common symptoms of this condition is experiencing a gradual decrease in vision clarity. You may notice that your vision is not as sharp as it once was, and things appear blurry or clouded.
  • Photophobia (Light Sensitivity): Increased sensitivity to light is another common symptom. You may find bright lights uncomfortable or even painful.
  • Foreign Body Sensation: You may feel like there's something in your eye, even when there isn't. This sensation can be persistent and very discomforting.
  • Recurrent Corneal Erosions: This refers to recurring damage to the outermost layer of the cornea. Erosions lead to symptoms like severe eye pain, redness, and increased sensitivity to light.
  • Night Vision Difficulty: As GCD progresses, you may find it increasingly difficult to see clearly in low-light conditions or at night.
  • Progressive Vision Loss: Over time, without appropriate management, GCD can lead to an ongoing loss of vision.
  • Halos Around Lights: Another indication of GCD is seeing rings or halos around lights, especially at night.

These symptoms can significantly impact your quality of life, but with appropriate treatment, it is possible to manage them effectively. If you've noticed any of these symptoms, please reach out to your eye doctor.

Unveiling the Types of Granular Corneal Dystrophy

There are two primary types of granular corneal dystrophy (GCD):

Type 1 Granular Corneal Dystrophy (Classic GCD): The granular opacities usually appear in both eyes during childhood or adolescence. These granules increase and may merge over time, leading to vision impairment.

Type 2 Granular Corneal Dystrophy (Avellino Corneal Dystrophy): Along with the granular opacities, this type also presents with lattice-like lines in the cornea. Symptoms often appear later in life and progress more slowly than Type 1 GCD.

Treatment Options for Granular Corneal Dystrophy
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