The Hypertonic ‘Solution’ For Corneal Edema

One of the most common eye issues that people face is corneal edema or the swelling up of the cornea which is the thin transparent layer at the front of the eyeball. The inner layer of cells of the cornea called the endothelium pushes any liquid that builds up within the cornea to have a clear vision and healthy eyes. Its damage causes vision impairment.

Symptoms, Causes, and Treatment of Corneal Edema

Here are the main symptoms of a swollen cornea:

  • Blurry vision for a prolonged period
  • Unusual halos or a certain glare around lights
  • Sensitive to touch or harsh lights
  • A certain irritable scratchy or itchy sensation in the eye
  • If left untended for extended periods, a severe symptom includes the formation of styes or blisters on or around the eye

If a patient has any of these prevalent issues, they must be taken to an ophthalmologist without delay to figure out the cause, diagnosis, and treatment. Some of the main causes of corneal swelling include:

  • Fuch’s endothelial dystrophy
  • Gradual deterioration of endothelial cells
  • Hereditary condition
  • Complications post-surgery
  • Irritation by an exterior body such as contact lenses
  • Allergy to some sort of medication or other treatment or condition

Once the doctor examines the eye and checks for clouding of the cornea or its thickness and ascertains the issue as corneal edema, they give one of the following treatments that vary on a case-to-case basis depending on the type and severity of the problem:

  • Hypertonic solutions such as sodium chloride ophthalmic solution USP 5 to reduce swelling
  • Semi-solid hypertonic ointments such as Akorn sodium chloride ointment
  • Oral medications including antibiotics, beta-adrenergic blockers, or corticosteroids
  • Thin breathable bandage contact lenses usually soothe and heal blisters

Hypertonic Ophthalmic Solution

The most common solution for corneal swelling is sodium chloride ophthalmic solution USP 5 which can be purchased without prescriptions but should be used with discretion. Hypertonic ophthalmic solutions should be used only if advised by an ophthalmologist or a local pharmacist and often cannot be used if the patient is pregnant or breast-feeding.

To apply the eye drops, make sure that your contact lenses are removed and your hands are clean before touching your face. Tilt your head slightly backward and hold your lower eyelid in such a way that it creates a pocket for the solution to sit in. Without touching the nib of the eye drop bottle to your eye, drop in the prescribed amount of solution into the pocket in both eyes and keep your eyes shut for around 1-2 minutes. Be sure not to rub your eyes or squeeze your eyelids too tightly. Replace the cap of the eye drops bottle to ensure the solution does not get contaminated.

Repeat this process about 2-3 times a day or according to your doctor. Check the solution for debris or discoloration before using it to ensure that it is not contaminated. If the symptoms and swelling do not reduce within the next 2-3 days or your eye unusually reacts to the medicine, call your doctor or go to the hospital to get it checked out before it gets worse.

Hypertonic Ophthalmic Ointment

Corneal edema can also be treated using hypertonic ophthalmic ointments such as Muro 128 or Akorn sodium chloride ointment. Akorn is a brand that cares for its customers and provides them with the highest quality products for both humans (Akorn Consumer Health and Akorn Eye Care) as well animals (Akorn Animal Health). For corneal edema, Akorn sells over-the-counter sodium chloride ophthalmic ointment with 5% hypertonicity. It comes in a 3.5 g size that cannot be frozen and should be stored at room temperature.

To use the ointment that is prescribed by the doctor, the patient must remove their contacts if they have any and wash their face and hands in preparation. Once that is done, they must pull down their lower lid to create a pocket and tilt their head slightly backward. A small ribbon of the ointment is then to be squeezed and applied into this pocket. They must then gently shut their eyes and leave it closed for about 1-2 minutes to allow the ointment to be spread throughout the surface of the cornea. Any excess ointment that leaks out of the eye is to be gently wiped away using a tissue.

Use 1-2 times a day for about 2-3 days, based on the doctor’s prescription. If no improvement is visible within the next 48 hours be sure to inform your doctor. Other than some mild temporary irritation post-application of the ointment, any other issues or allergies need to be communicated to the doctor immediately to prevent the worsening of the situation.