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Fuchs Dystrophy and Glaucoma

Fuchs Dystrophy and Glaucoma

What is Glaucoma?

Glaucoma is damage to the optic nerve in the back of the eye.  In glaucoma, the damage to the optic nerve is usually due to increased pressure inside the eye.  The pressure inside the eye is known as intraocular pressure (IOP).   The optic nerve is crucial for vision because it sends the information from the eye to the brain.  Without the optic nerve, the brain would never know what the eye was seeing, and the eye would therefore be useless.    

In healthy eyes, the aqueous humor (the clear liquid in the front part of the eye) exerts pressure to maintain proper eye structure. If this aqueous humor were not there, the cornea would collapse inward like a water balloon without any water in it.  Normally, this aqueous humor (fluid) is constantly being produced and constantly draining in order to keep the pressure exactly right.  When the aqueous humor is unable to drain, the pressure in the eye increases.  This increased pressure presses on the optic nerve.  If the pressure stays high for a long enough period of time, the optic nerve will be damaged.  This will result in blind spots in the patient’s vision because the transmission of the “picture” from the eye to the brain will be interrupted.  The longer glaucoma is left untreated, the more blind spots will develop.  This can result in a person’s vision becoming significantly impaired.  

Intraocular Pressure Affects the Corneal Endothelium

It is important to for surgeons to carefully control the intraocular pressure (pressure inside the eye) during and after a patient’s corneal transplant surgery.  Eye doctors have done research to show that when eye pressure goes up, there can be lots of damage to the corneal endothelium.  It is never good for there to be damage to the corneal endothelium.  However, in a patient who has just had a corneal transplant, damage to the corneal endothelium can mean that the surgery will have to be re-done.

In fact, glaucoma is the second most common cause of transplant failure.

view video of trabeculectomyVideo of trabeculectomy with corneal graft, removal of cataract, and insertion of intra-ocular lens

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