Corneal Edema Symptoms, Causes & Treatments

What is Corneal Edema?

Corneal edema is a condition that is characterized by the swelling of the eye’s cornea. The cornea is the clear tissue layer of the eye that transmits and focuses light so that you can see. It’s made up of five important layers:

1. Epithelium
2. Bowman’s Membrane
3. Stroma
4. Descemet’s Membrane
5. Endothelium

Each layer works in unison to capture light, which ultimately enhances your vision. The cornea, therefore, is an integral part of your eye. Damage to the cornea can significantly impair your vision and affect the proper functioning of your eye. 

While corneal edema occurs most often in people who are 50 years old or older, anyone at any age can develop the eye condition.

What Causes Corneal Edema?

There are a few common causes of corneal edema. Corneal edema can happen when the cornea becomes inflamed (known as keratitis) due to medical conditions like herpes simplex viral infections. Or it can develop after the use of certain medications or from wearing irritating contact lenses too often. 

In the case of glaucoma, the eye’s intraocular pressure may be too high and affect the cornea. You can also develop corneal edema after eye surgery, such as cataract surgery. This is because intraocular procedures can damage the cornea.

While corneal edema may be due to an underlying cause, most commonly, it happens when there’s a buildup of fluid in your eye. The endothelium of the cornea controls the build-up and release of fluid. You can damage the endothelium of your cornea and develop corneal edema a few ways:

• Fuchs’ endothelial dystrophy (a disease that affects the endothelial cells)
• Endotheliitis (an immune response to herpes)
• Other endothelial dystrophies
• Other ocular diseases
• Ocular trauma
• Infections
• Corneal transplant problems 
• Eye surgery
• Over-wearing contact lenses

What are the Symptoms of Corneal Edema?

Corneal edema can be uncomfortable due to swelling of the cornea and any endothelial damage. You may experience some or all of these symptoms if you have corneal edema:

• Eye pain
• Glare
• Blurriness
• Distorted eyesight
• Seeing halos or rings around light
• Increased sensitivity to light
• Eye soreness
• Scratching sensation in the eye
• Blisters on the cornea (in severe cases)

Diagnosis of Corneal Edema

Your ophthalmologist will have a conversation with you about your symptoms and medical history before conducting an eye exam to look at your cornea. They’ll look out for any clouding of your cornea by using magnifying tools such as slit lamps and ophthalmoscopes. They may also do an ultrasound on your eye or measure your cornea’s thickness via a process that is known as pachymetry.

If you are diagnosed with corneal edema, your ophthalmologist will share and discuss some treatment options for you. It’s important to weigh your options given the severity of your diagnosis, budget, lifestyle, and other factors.

Corneal Edema Treatment 

Fortunately, there are both surgical and non-surgical options to treat corneal edema. Depending on your diagnosis, some surgical treatment options may include the following:

• Corneal transplant
• Lens implant exchanges (a dislocated lens implant may cause corneal edema)
• Removal of vitreous materials or remaining lens materials after cataract surgery
• Descemet Stripping Endothelial Keratoplasty (DSEK) to replace the corneal endothelium through a small incision

If your case isn’t so severe, non-surgical treatment options may include the following:

• Switching to a new type of contact lenses
• Switching to glasses instead of contact lenses
• Taking antiviral drugs (for herpes infections), beta-adrenergic blockers (or other glaucoma medications), or corticosteroids (to reduce inflammation)
• Using ointments
• Taking diuretics
• Using hypertonic saline drops
• Using prescription eye drops
• Using a bandage contact lens
• Practicing general eye care

Corneal Edema FAQs

Here are answers to some of the most frequently asked questions about corneal edema.