Fuchs' dystrophy

A degenerative eye disease affecting the cornea

Fuchs' dystrophy is a progressive eye disease that affects the cornea, the clear, dome-shaped surface that covers the front of the eye. It is characterized by the gradual deterioration of the corneal endothelium, the innermost layer of the cornea, leading to vision problems.

Pathophysiology

Corneal changes in Fuchs' dystrophy

Fuchs' dystrophy is primarily caused by the loss of endothelial cells in the cornea. These cells are responsible for maintaining the proper balance of fluids within the cornea by pumping excess fluid out. As these cells deteriorate, fluid accumulates, causing the cornea to swell and thicken, leading to corneal edema. This results in blurred vision and can cause corneal clouding.

Symptoms

The symptoms of Fuchs' dystrophy typically appear in both eyes and may include:

• Blurred or cloudy vision, especially in the morning
• Glare and sensitivity to light
• Difficulty seeing at night
• A sensation of having a foreign body in the eye
• Painful, small blisters on the surface of the cornea (advanced stages)

Diagnosis

Fuchs' dystrophy is diagnosed through a comprehensive eye examination. An ophthalmologist may use several tests to assess the condition of the cornea, including:

• Slit-lamp examination to observe the corneal endothelium
• Specular microscopy to count endothelial cells
• Pachymetry to measure corneal thickness

Treatment

In the early stages, treatment may focus on managing symptoms. This can include the use of:

• Hypertonic saline eye drops or ointments to reduce corneal swelling
• Soft contact lenses to protect the cornea

In advanced cases, surgical intervention may be necessary. Surgical options include:

• Endothelial keratoplasty, such as Descemet's stripping endothelial keratoplasty (DSEK) or Descemet membrane endothelial keratoplasty (DMEK)
• Penetrating keratoplasty (full-thickness corneal transplant)

Prognosis

The progression of Fuchs' dystrophy varies among individuals. While some may experience only mild symptoms, others may develop significant vision impairment. With appropriate treatment, many patients can maintain good vision.

Related pages

• Corneal transplant
• Keratoconus
• Cataract