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The eye’s outermost tissue, the cornea, is a bit more substantial than you might imagine. It’s made up of lots of types of cells and structural proteins, arranged in highly organized layers. At about 560 µm (1/45 of an inch), the cornea is transparent, but about as thick and bendy as a credit card. For clear vision, it must be free of cloudy areas, but disorders can roll over it like a storm — the most common being an inherited, degenerative disease called Fuchs’ corneal dystrophy. Fuchs’ (pronounced “fooks”) affects almost five percent of middle-aged patients with some variance across ethnicities. Most people remain symptom free, but many lose their vision altogether; Fuchs’ accounts for more than 14,000 corneal transplantations in the U.S. annually.
On Mayo Clinic’s Rochester, Minn. campus, surgeon Keith Baratz, M.D., meets and treats Fuchs’ patients almost every day. The disease slowly kills off the cells responsible for regulating the amount of fluid entering the cornea. As the cells die, the first symptom patients usually notice is blurred morning vision. This happens because when their eyes are shut as they sleep, fluid builds up in the cornea, causing it to swell. While their eyes are open over the course of the day, the excess fluid evaporates, so they usually see better by evening. But as the disease advances, the periods of swelling, impaired vision and pain last longer. Read the rest of the article.
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