Corneal Endothelial Failure
The cornea consists of five main layers, with a sixth layer of uncertain significance having being recently described. The innermost layer, known as the corneal endothelium, is a single layer of cells responsible for maintaining the clarity of the cornea. Theses cells have a pump function, continuously pumping fluid out of the cornea, keeping this clear and thin.
Corneal endothelial cells do not regenerate throughout our lives and it is normal for the number of cells to gradually decline. A number of factors can accelerate the rate of decline, for example disease or eye surgery.. Some people are born with a pre-disposition to faster than normal endothelial cell decline, most commonly Fuchs’ corneal endothelial dystrophy. Once the number of cells reaches a critical level, they are unable to maintain their pump function and the cornea becomes thickened and hazy. This has a significant impact on vision, initially causing blurry vision typically in the mornings, extending to lasting all day as the condition worsens.