- Compromised endothelial cell pump mechanism as the endothelial
cell density decreased and decompensated.
- Can be secondary to congenital endothelial dystrophies, trauma,
cataract or other surgical trauma, anterior chamber intraocular lens
and prolonged inflammation.
- Clinical features:
- Symptoms:
- Mild to severe decreased vision
- Painful from epithelial and subepithelial breakdown of the
bulla
- Tearing
- Sensitivity to light
- Decrease or loss of corneal sensation in advanced stage
- Signs:
- Epithelial and stromal edema
- Microcysts and bulla formation
- Subepithelial scarring from resolved chronic edema
- Management:
- Hyperosmotic sodium chloride 5% drops and ointment.
- Soft contact lens to control the pain.
- Intraocular pressure lowering medications.
- Surgical: penetrating keratoplasty in advanced cases.
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