Corneal dystrophy – what causes cloudiness in the eye?

This disease, also known as endothelial dystrophy, is a change in the cornea of the eye and is similar to Fuchs' dystrophy in humans. This disease causes damage to the endothelial cells that form the innermost layer of the cornea.

INHALT
Cause and origin Symptoms Diagnosis Treatment Forecast Prophylaxis
Cause and origin

The exact cause of the disease is still unknown. However, as the disease occurs more frequently in some breeds, a hereditary component is suspected. Predisposed breeds include poodles, wire-haired dachshunds, Boston terriers, and Chihuahuas. The disease mainly occurs in dogs over the age of five.

The endothelial layer of the cornea regulates the fluid content of the cornea. Endothelial cells cannot be regenerated by the body. If they are destroyed, the aqueous humor can penetrate the cornea unhindered and cause it to swell. This results in clouding of the cornea, known as corneal edema.

Symptoms

A bluish clouding of the cornea, occurring on one or both sides, is the first sign of the disease that is noticeable to the owner. The clouding may occur in a specific area or be diffuse across the entire cornea. Affected animals may show itching, eye discharge, and increased blinking.

As the disease progresses and fluid accumulates, small blisters may form on the outside of the cornea. When these blisters burst, it is very painful for the animal. This results in corneal defects that can significantly impair vision or lead to complete loss of vision. The pain causes the affected animals to squint and try to scratch their eyes.

Dog with cloudy cornea
Dog with clouding of the cornea
Diagnosis

After a thorough clinical examination and review of the preliminary report, the attending veterinarian will usually be able to make an initial diagnosis. To confirm the diagnosis and rule out other causes of corneal opacity, a special examination of the eyes is necessary. This involves using various technical instruments (e.g., slit lamp, endothelium microscope) to examine the different areas of the eye in detail.

Treatment

Since the destroyed endothelial cells do not regenerate, the disease is considered incurable. However, treatment of the affected eye is essential. Appropriate medication in the form of special eye ointments or drops can prevent the disease from progressing and new blisters from forming. In most cases, however, corneal opacity or corneal defects that have already developed cannot be completely eliminated in this way.

In cases of non-healing defects or persistent pain, the veterinarian will therefore recommend surgical treatment. This involves removing the damaged areas of the cornea and transplanting a thin section of the conjunctiva into the cornea. Although this procedure, known as a Gunderson flap, also restricts vision, the blood supply to the transplanted conjunctiva ensures that fluid is removed from the damaged cornea, allowing it to become clearer again. The operation also relieves pain and prevents the disease from spreading further. In parallel with the operation, animals suffering from endothelial dystrophy must be treated with appropriate eye drops for the rest of their lives.

Forecast

The disease is incurable. The prognosis regarding the ability to retain vision depends greatly on the extent and severity of the disease. If the disease is treated surgically at an early stage, it is usually possible to preserve a large part of the patient's vision. Complete blindness can be prevented in most cases using the Gunderson flap.

Prophylaxis

Since it is largely a hereditary and age-related disease, prevention is virtually impossible.