Fuchs’ Corneal Dystrophy

Fuchs’ corneal dystrophy is a disorder of the front surface of the eye (cornea) that usually impacts older adults. Here are essential facts about Fuchs’ dystrophy you need to understand:

What Is Fuchs’ Dystrophy?

Fuchs’ dystrophy (fooks DIS-truh-fee) is an eye disease in which the inner layer of cells in the cornea goes through degenerative modifications. This cell layer, called the endothelium, is responsible for preserving the correct amount of fluid in the cornea. The endothelium keeps the cornea clear for good vision by pumping out excess fluid that could cause corneal swelling.

Likewise called Fuchs’ corneal dystrophy and Fuchs’ endothelial dystrophy, the disease usually impacts both eyes and causes a progressive decrease in vision due to corneal edema (swelling) and clouding.

As the disorder progresses, swelling of the cornea can cause blisters on the front of the cornea known as epithelial bullae (BULL-eye). This condition is called bullous keratopathy.

There is no known avoidance for Fuchs’ dystrophy.

 

Fuchs’ Corneal Dystrophy

Fuchs’ dystrophy can have a genetic cause, however it likewise can occur without a previous family history of the disease. Oftentimes, the cause is unknown.

What Are the Symptoms of Fuchs’ Dystrophy?

Fuchs’ dystrophy symptoms include:

• Glare and sensitivity to light
• Eye pain
• Foggy or blurred vision
• Seeing colored halos around lights
• Trouble seeing at night
• Poor vision upon awakening that might enhance later in the day
• A sensation that something remains in your eye (foreign body experience)

Who Is Most At Risk For It?

Vision issues from Fuchs’ corneal dystrophy generally affect people after age 50, though eye doctors can detect early signs of the disease in younger grownups. It appears to be more common amongst women than men.

If your mother or dad has Fuchs’ dystrophy, you have approximately a 50 percent possibility of getting the disease.

How Is It Detected

A comprehensive eye examination by an optometrist or eye doctor is needed to identify Fuchs’ corneal dystrophy.

During the exam, your eye doctor will use an instrument called a slit light to perform a comprehensive evaluation of the cornea. During this procedure, she or he will take a look at the cornea under high magnification to search for subtle modifications in the appearance of cells in the endothelium that are particular of the disease.

The early clinical signs of Fuchs’ dystrophy are a reduced variety of endothelial cells and tiny drop-like sores in the corneal endothelium called corneal guttata.

Another test your optometrist might carry out is a measurement of your corneal thickness (pachymetry), to identify increased corneal density that might indicate corneal swelling from the disease.

Also, visual skill testing with an eye chart that is done during an extensive examination can reveal reduced vision due to corneal swelling.

What Treatment Is Available For Fuchs’ Dystrophy?

Treatment for Fuchs’ dystrophy depends on the stage of the disease. In the early cases, vision frequently can be improved by getting rid of excess water from the cornea with 5% sodium chloride (hypertonic) eye drops.

If you have endothelial dystrophy and ocular hypertension, your eye doctor might suggest glaucoma eye drops to lower your intraocular pressure (IOP). High eye pressure can damage the corneal endothelium, worsening Fuchs’ dystrophy.

As the disease progresses, the epithelial bullae can burst, triggering painful corneal abrasions and poor vision. If this happens or if Fuchs’ dystrophy advances to the point of triggering considerable vision loss, a cornea transplant normally is needed.

An alternative to a full-thickness corneal transplant (also called permeating keratoplasty, or PK) is deep lamellar endothelial keratoplasty (DLEK), which is a surgical technique to change the endothelium that leaves the upper layers of the cornea unblemished. This procedure has actually revealed success for the treatment of Fuchs’ dystrophy with possibly less threats than penetrating keratoplasty.

Over the last few years, an innovative form of DLEK called femtosecond laser-assisted Descemet stripping endothelial keratoplasty (FS-DSEK) has revealed motivating results for treatment of the disease.

Safety measures

If you have actually been diagnosed with Fuchs’ corneal dystrophy, make sure to discuss this with your eye doctor if you are thinking about LASIK or other refractive surgery or if you have cataracts and need cataract surgery. These eye surgical treatments can worsen the condition, and corneal dystrophy typically is considered a contraindication for elective refractive surgery.