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Cornea guttata is an eye condition in which collagen cells collect and grow abnormally at the back of the eye, forming small lumps — known as “guttata” — that can be painful and may also cause a number of vision problems, including light transmission issues and blurriness. The condition can happen for a number of reasons, but eye injury and cataract surgery are some of the most common; a disorder known as Fuch’s dystrophy may also be to blame. In most cases eye specialists can remove the buildups and restore a person’s vision, but it’s not always possible to prevent more growths from appearing. People who are predisposed often need regular treatment and are sometimes prescribed drugs to keep the condition from worsening.
The cornea sits in what is basically the front-center of the human eye, and is responsible for filtering light. It is translucent and covers the colored part of the eye, known as the iris, and the black part of the eye, which is the pupil. At the edges of the cornea, the translucency changes into the white sclera, which protects the rest of the eyeball from outside elements.
A normal cornea is rather complex. The outer edge contains the epithelial cells, which in turn covers the Bowman's layer, which is made of collagen. Inside the thin Bowman's layer is a thick layer called the stroma, which is dense with collagen fibers. Under this is the Descemet's layer, which is also a collagen layer. The lowest layer of the cornea is the endothelium, which is made up of endothelial cells that move excess fluid out of the stroma and help keep the cornea transparent. When guttata happen, they typically happen here.
Collagen usually accumulates at the back of the cornea when the endothelial cells do not grow properly. Sometimes they may reproduce on top of each other, or they may die off prematurely; in either event, the result it often deep “gaps” or ridges of collagen that form bumps. Most of the time this happens as a result of some sort of genetic defect, but irritation from long-term contact lens use and normal aging can also be factors. At first the buildups aren’t usually a problem, and the eye can function just fine. After decades of growth, though, people often start experiencing problems.
Collagen problems might also happen as a result of eye trauma or injury. Improper healing from cataract surgery or laser vision correction can cause bumps to form, particularly if cuts went too far or too deep. The eye sometimes overcorrects in its own healing process, and in these cases the guttata may arise much more quickly, often within a few months of the triggering event.
People don’t normally notice collagen bumps until they have a vision problem. Patients experience a misty appearance to their sight, which can get worse over time; blurriness is also common, particularly in the mornings or just after waking. In most cases the eyes look just fine, and diagnosis generally requires a professional assessment. Opthalmologists can usually spot these abnormalities pretty quickly. In most cases they appear as dark spots when viewing the eyeballs though a special tool known as a slit lamp.
The goal of most cornea guttata treatment is to restore a person’s vision, though it isn’t always possible to completely cure the problem — sometimes simply removing the irritant, like a contact lens, will do the trick but not always. If collagen buildup has been happening for years on end it is often very difficult to reverse. People can cope by using saline eye drops or other lubricating measures, and conversely drying the surface of the cornea, often with warm air, can also be a means of temporary relief.
Prescription eye drops with drugs designed to dissolve the guttata can be helpful in very serious situations, but if these don’t work people may need surgery. Eye experts usually only recommend eye surgery for people whose vision is seriously impaired, though. It carries its own set of risks and is usually quite invasive.
Not all blurred or misty vision is caused by cornea guttata, but when it is, the earlier the condition is caught the easier it often is to treat. Eye care professionals usually recommend that anyone who is experiencing vision problems or eye pain make an appointment for an evaluation to rule out this and other related conditions. Regular, preventative eye care can also go a long way towards reducing the risk of future problems, too.