Fuchs Dystrophy

Overview

Fuchs dystrophy (also known as Fuchs endothelial dystrophy) is an eye condition that affects the innermost layer of the cornea: the corneal endothelium. It is more common in women and although it is more commonly sporadic (not inherited), it does sometimes run in the family, in an autosomal dominant fashion.

In Fuchs dystrophy, the endothelium gradually loses its ability to pump water out of the cornea, which is necessary for preventing swelling and maintaining a transparent cornea. As a result, vision becomes blurred and the eye doctor will be able to detect signs of Fuchs dystrophy when he/she views the layers of the cornea under high magnification. Once endothelial cells are lost, they cannot be regenerated, so surrounding cells enlarge to compensate, but cannot possibly work as efficiently.

Signs & Symptoms of Fuchs Dystrophy

In the early stages of Fuchs dystrophy, patients will notice a sensitivity to light as well as increased glare. As the endothelial cells are lost and the pump's efficiency is reduced, vision will progressively worsen. Patients may also notice that vision improves during the day – this is because during sleep, moisture is retained in the eyes much more than during the day when evaporation takes place in eyes that are open. Occasional pain may also occur in the later stages of Fuchs dystrophy as epithelial cells bulge and then rupture, exposing nerve endings.

Detection & Diagnosis of Fuchs Dystrophy

Changes in the endothelial layer of the cornea can be detected upon close inspection using a slit lamp biomicroscope. As Fuchs dystrophy progresses, the endothelial cells will become larger and larger.

Fuchs Dystrophy Treatment

Unfortunately, there is no cure for Fuchs endothelial dystrophy. However, there is a number of options available for controlling the swelling. Salt solution (sodium chloride 5%) drops can be used, which draw moisture out of the cornea. An even simpler solution is to hold a blow dryer at arms length and blow warm air into the face (with eyes closed). This will temporarily draw moisture from the eyes and improve vision.

In cases where Fuchs dystrophy can no longer be controlled by simple methods like salt solution drops, a corneal transplant may be in order. Such a surgery is highly risky and should only be performed when a patient's vision has deteriorated to the point where he/she can no longer function normally.

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