Bullous keratopathy is characterized by the development of bullae in the cornea, due to the endothelial cells degenerating at an abnormally fast rate. As these cells are lost, there is a gradual buildup of fluid, since the cells can no longer properly pump the fluid out of the inner cornea. As a result, the cornea is damaged and becomes permanently swollen (corneal edema), which leads to clouding and swelling. Those who suffer from bullous keratopathy typically experience eye discomfort and reduced vision, which can gradually worsen if left untreated.
Bullous keratopathy is typically caused by previous trauma or a complication from surgery. In the past, the condition most often occurred following cataract surgery as a result of the cataract removal or placement of the intraocular lens (IOL). When bullous keratopathy results from cataract surgery, it is “pseudophakic” if an IOL is present and “aphakic” if no IOL has been placed. Older types of IOLs were associated more with bullous keratopathy. With the advanced devices used in today’s procedures, the condition is very rarely caused by cataract surgery.
Aside from cataract surgery, bullous keratopathy can be caused by Fuchs’ dystrophy as well as following glaucoma surgery if excess endothelial cells are damaged in the process. Other risk factors for developing bullous keratopathy include being of an advanced age, having a dense cataract, and the history of an eye trauma.
Treating Bullous Keratopathy
Although bullous keratopathy cannot be cured, the associated symptoms can often be controlled with the right treatment options. At Eye Doctors of Washington, our experienced ophthalmologists will first make a diagnosis using a slit lamp, corneal topography, and specular microscope. After assessing the cell damage and determining the rate of the disease’s progression, our surgeons can then recommend the best course of treatment.
If the corneal edema (or swelling) is in an earlier stage, prescribed eye drops or ointment may be sufficient to help relieve the discomfort and swelling. A bandage contact lens is also beneficial for certain individuals who experience significant discomfort. Patients who suffer from a more advanced stage of bullous keratopathy may require a corneal transplant or amniotic membrane graft to replace the damaged cornea, helping create long-term relief and vision improvement from the progressive disease.
For those who may be suffering from bullous keratopathy, or would like to learn more about the condition, please schedule an appointment with one of our corneal specialists.