Chandler's disease

A rare eye disorder affecting the corneal endothelium

Chandler's disease is a rare eye disease that is part of a group of disorders known as the iridocorneal endothelial syndrome (ICE). It primarily affects the corneal endothelium, leading to corneal edema and changes in the iris and anterior chamber angle, which can result in glaucoma.

Pathophysiology

Chandler's disease is characterized by an abnormality in the corneal endothelial cells. These cells, which normally maintain corneal transparency by pumping fluid out of the cornea, proliferate abnormally and migrate across the anterior chamber, leading to corneal edema. The endothelial cells in Chandler's disease have a "hammered silver" appearance when viewed under a slit lamp.

Clinical Features

Patients with Chandler's disease often present with blurred vision due to corneal edema. The disease is usually unilateral, affecting only one eye. Other symptoms may include halos around lights and mild eye discomfort. The iris may show atrophy, and the anterior chamber angle may be affected, leading to secondary glaucoma.

Diagnosis

Diagnosis of Chandler's disease is primarily clinical, based on the characteristic appearance of the corneal endothelium and associated symptoms. Gonioscopy may reveal peripheral anterior synechiae, and tonometry is used to assess intraocular pressure, which may be elevated due to glaucoma.

Treatment

The management of Chandler's disease focuses on controlling intraocular pressure and addressing corneal edema. Topical medications such as beta-blockers, carbonic anhydrase inhibitors, and prostaglandin analogs are commonly used to manage glaucoma. In cases where medical therapy is insufficient, surgical options such as trabeculectomy or glaucoma drainage devices may be considered.

For corneal edema, hypertonic saline drops can be used to draw fluid out of the cornea. In advanced cases, corneal transplantation may be necessary to restore vision.

Prognosis

The prognosis for Chandler's disease varies. While some patients maintain good vision with treatment, others may experience progressive vision loss due to corneal decompensation or uncontrolled glaucoma.

Related pages

• Iridocorneal endothelial syndrome
• Corneal endothelium
• Glaucoma
• Corneal transplantation

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