H18.13

Clinical Causes: Corneal endothelial cell dysfunction or damage, often following intraocular surgery such as cataract removal. Fuchs' endothelial dystrophy, a progressive disease where the corneal endothelium deteriorates over time. Glaucoma or increased intraocular pressure leading to endothelial damage. Corneal injuries or trauma that impair the endothelium. Contact lens overuse or misuse which can harm corneal cells. Certain medications or chronic eye inflammation that damage the corneal layers.

Key Symptoms: Blurred or hazy vision in both eyes. Seeing water or blister-like bubbles on the cornea. Sensitivity to light (photophobia). Tearing or watery eyes. Discomfort or a feeling of pressure in the eyes. Difficulty seeing in low light conditions.

Diagnosis Path: A healthcare professional typically conducts a comprehensive eye examination, including slit-lamp microscopy, to observe the corneal surface and detect blistering or swelling. Additional tests may include corneal topography or pachymetry to measure corneal thickness. A detailed patient history can reveal prior eye surgeries or conditions that might have contributed to the development of bullous keratopathy.

Treatment Protocols: Management of bilateral bullous keratopathy depends on severity. Options may include: - **Medical therapy**: Use of hypertonic saline eye drops or ointments to reduce corneal swelling. - **Protective measures**: Wearing sunglasses or protective eyewear to shield the eyes from irritants. - **Surgical interventions**: Corneal endothelial transplantation procedures, such as Descemet's Membrane Endothelial Keratoplasty (DMEK), to restore corneal clarity. - **Speech and vision rehabilitation**: Adaptations to improve quality of life if vision loss occurs. Regular follow-up with an ophthalmologist is essential to monitor the condition and adjust treatment plans accordingly.