Fuchs’ Corneal Dystrophy

Reviewed by Arefa Cassoobhoy, MD, MPH on August 20, 2020

What Is Fuchs’ Corneal Dystrophy?

Fuchs’ corneal dystrophy is a genetic eye disease. In the early stages, it causes bumps called guttae to form on cells in your cornea. In the late stages, it can make your cornea swell. Either can make your vision blurry, but later on, the symptoms can be so severe that it’s hard for you to drive, read, watch television, or take part in other daily activities.

 

Fuchs’ Corneal Dystrophy Symptoms

If you have this condition, you were born with it, but you probably won’t have symptoms until your 30s or 40s. For most people, problems don’t appear until they’re 50 or older. Fuchs’ has two major stages, each with different symptoms.

Stage 1: Your vision is hazy in the morning but clears up as the day goes on. That’s because the fluids in your cornea build up while you sleep, then dry out while you’re awake.

Stage 2: Your vision stays blurry for several hours or doesn’t clear up at all. Blisters can form on your cornea. They might break open and cause eye pain. In the last stages, scars on your cornea can lead to major vision loss.

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Other symptoms include:

  • The feel of sand or grit in your eyes

  • Glare in bright light

  • Trouble with night vision

  • Halos that appear around lights

When you have Fuchs’ corneal dystrophy, symptoms get worse gradually. Talk to your eye doctor if you notice any symptoms. If symptoms come on suddenly, get checked out right away. It’s probably something else that may need urgent treatment.

Fuchs’ Corneal Dystrophy Causes and Risk Factors

The innermost layer of your cornea, called the endothelium, removes fluids from the cornea to keep it clear. If you have Fuchs’, those cells start to die off. Fluid levels rise, and your cornea swells. Over time, your vision will get cloudy or hazy.

Doctors have found these risk factors:

  • Genes: If your family has a history of Fuchs’, you’re more likely to get it.

  • Gender: It’s more common in women than men.

Fuchs’ Corneal Dystrophy Diagnosis

Your doctor may first notice the disease during a routine eye exam when they use a special microscope called a slit lamp. This allows them to see the innermost layer of your cornea. They may also see small bumps on your cornea that are a telltale sign of Fuchs’.

Your doctor might check your eye pressure to rule out glaucoma, which raises eye pressure and can make you see halos. Then they'll measure the thickness of your cornea.

Fuchs’ Corneal Dystrophy Treatment

There’s no cure for Fuchs’ dystrophy. But you have several treatment choices, depending on what stage you’re in.

Medications

Eye drops or ointments:Some medicines may ease the swelling in your cornea. Saline drops can pull out moisture. Either treatment may ease cloudy or hazy vision.

Surgery

If you’re in the late stages of Fuchs’, your doctor may suggest a cornea transplant. There are two types:

Endothelial keratoplasty:This is a partial transplant. The doctor replaces the inner layers of your cornea with healthy donor tissue. This method uses a few sutures, or no sutures at all, which helps you recover faster. Some people have 20/20 vision, with glasses, just days after surgery. But most people take longer. Because it’s a partial transplant, your body is less likely to reject the donor tissue. This method makes up about 90% of cornea transplants in the United States.

Penetrating keratoplasty: Doctors usually call this a full transplant, because they replace the center two-thirds of your cornea with donor tissue. It takes longer to recover from this surgery. It could be a year until your complete vision returns. This type of transplant also has a higher risk of rejection and injury.

Fuchs’ Corneal Dystrophy Complications

If you have a transplant, it’s possible your body may start to reject it. Signs that your body is rejecting the donor tissue include:

  • Eye pain

  • Sensitivity to light

  • Eye redness

  • Cloudy or hazy vision

Tell your doctor right away if you notice any of these symptoms, or if you have other unusual eye problems. They can give you medicine that might prevent a rejection.

Fuchs’ Corneal Dystrophy Prevention

There are no known ways to prevent Fuchs’ dystrophy. Doctors have more to learn about how the disease develops, the role of genes, and other risks like smoking.

For now, the best ways to treat the disease are eye drops or ointments to remove fluids and ease cornea swelling in the early stages. If you have advanced Fuchs’, the best treatment is a cornea transplant.

WebMD Medical Reference

Sources

SOURCES:

American Academy of Ophthalmology: “Corneal Transplant Surgery Options,” “Fuchs’ Dystrophy,” “What to Expect When You Have a Corneal Transplant.”

Cornea Research Foundation of America: “Endothelial Keratoplasty (DSEK & DMEK),” “Fuchs’ Dystrophy.”

Wilmer Eye Institute, Johns Hopkins School of Medicine: “Fuchs Endothelial Corneal Dystrophy.”

Mayo Clinic: “Fuchs’ Dystrophy.”

Expert Review Of Ophthalmology: “Fuchs’ corneal dystrophy,” “The genetics of Fuchs’ corneal dystrophy.”

Glaucoma Research Foundation: “What are the Symptoms of Glaucoma?”

Johns Hopkins Medicine: “Fuchs’ Dystrophy.”

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