Fuchs’ endothelial dystrophy causes your cornea to swell and thicken

Symptoms include glare, blurred or cloudy vision and eye discomfort

Fuchs’ endothelial dystrophy causes your cornea to swell and thicken

Symptoms include glare, blurred or cloudy vision and eye discomfort

Fuchs’ endothelial Dystrophy is an eye disease that affects the cornea

Fuchs’ can cause blurry vision or even blindness

Fuchs’ endothelial dystrophy is a hereditary eye disease with symptoms that often become noticeable after the age of 50. It affects the cornea’s endothelium (the innermost layer of the cornea).

The endothelium is just one layer of cells. Its job is to provide the appropriate balance of fluid in the cornea, keeping it thin and crystal clear.

Unfortunately, these cells undergo damage and cannot keep up with pumping fluid. Hence, the cornea begins to swell (known as corneal oedema). As a result, the cornea becomes thicker and cloudy, resulting in vision problems.

In advanced cases, tiny blisters can form on the surface of your cornea, which can be painful, so it is important to seek treatment before the condition worsens.

What are the symptoms?

If you have Fuchs’ dystrophy, one of the first signs may be that you begin to notice glare with headlights at night or in bright sunlight. As Fuchs’ dystrophy progresses, your vision may become foggy or blurry in the morning, and clear as the day progresses.

This occurs because evaporation of fluid from the cornea decreases while your eyes are closed during sleep. As a result, the fluid accumulates during the night, causing corneal swelling.

We can treat this early stage with a special salt solution or ointment to help pull the water out of your cornea. However, as the Fuchs’ progresses, your vision will stay blurry longer during the day. And over time, you may find your vision does not clear at all.

Normally, the cells lining the inside of the cornea (endothelial cells) help maintain a healthy balance of fluid within the cornea, and prevent swelling.

But with Fuchs’ dystrophy, the endothelial cells gradually die or simply do not work well, resulting in a fluid buildup (edema) within the cornea. This causes corneal thickening and blurred vision.

Fuchs’ dystrophy is usually inherited. The genetic basis of the disease is complex – family members can be affected to varying degrees or not at all.

Besides testing your vision, we may perform the following tests to determine whether you have Fuchs’ dystrophy:

  • Cornea examination and grading.
    Here we examine your eye with an optical microscope (slit lamp) to look for irregular bumps on the inside surface of the cornea. We will then assess your cornea for swelling and stage your condition.
  • Corneal thickness.
    We might use a test called corneal pachymetry to measure the thickness of the cornea.
  • Corneal tomography.
    We might obtain a special photograph of your cornea (tomography) to assess for early signs of swelling in your cornea.
  • Corneal cell count.

Sometimes we might use a special instrument to record the number, shape and size of the cells that line the back of the cornea. However, this test is not typically required.

The definitive treatment for this condition is to replace the diseased layer of endothelium and replace it with a new healthy graft from the corneal donor.

There are a couple of techniques for the transplantation: one is called descemet’s stripping automated endothelial keratoplasty (DSAEK), and the other is Descemet’s membrane endothelial keratoplasty (DMEK).

Corneal diseases are a leading cause of blindness and vision impairment all over the world

Early diagnosis and treatment is key to preventing further damage and restoring vision. Come see us today for an assessment.

Does your corneal eye condition hold you back in life?

If so, we can likely help stabilise or possibly reverse the effect

Talk to us about your corneal eye condition

Whether you’re suffering from an eye infection, corneal abrasion, dry eye, eye allergies or progressive conditions like keratoconus or Fuchs’ dystrophy, we can likely help alleviate symptoms and treat the root cause.

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Learn more about Corneal Disease & Ocular Surface Treatment from authoritative sources

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Early diagnosis and treatment is key to preventing further damage and restoring vision. Come see us today for an assessment.

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Mr Mohamed Elalfy

MBBCh, MSc, MD, DRCOphth, FRCS (Ed), FRCS (Glas), FRCOphth, FICO, FEBO
Consultant Ophthalmic Surgeon

Seeking eye treatment for a worrying eye condition can be stressful. Waitlists everywhere are long due to the lockdowns, and leaving the house to attend appointments can be a real inconvenience.

To make your experience as easy and stress-free as possible, we provide assessments in your local area. We also offer online appointments both before and after your treatment, so you don’t have to travel far to get the personalised support you deserve.