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.

How Does Fuchs’ Affect Your Vision?

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.

What Are the Symptoms?

Most of the time, the disease begins in your 30s or 40s, but problems don’t appear until your 50s or 60s. 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 remains 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 final stages, scars on your cornea can lead to major vision loss.

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

What Raises Your Chances of Having It?

Doctors have found these risk factors:

  • Genes: If your family has a history of Fuchs’, you’re more likely to get it.
  • Sex: It’s more common in women than men.

How Is Fuchs’ Diagnosed?

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

She might check your eye pressure to rule out glaucoma, which raises eye pressure and can make you see halos. Then she’ll measure the thickness of your cornea.

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How Is Fuchs’ Treated?

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.
  • Hair dryers: Holding a hair dryer at arm’s length and gently blowing warm air across your eyes may help ease swelling in your cornea.

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.

Could There Be Complications?

Yes, but they're rare. 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. She can give you medicine that might prevent a rejection.

Can Fuchs’ Be Prevented?

There are no known ways to cure or 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 Reviewed by Alan Kozarsky, MD on April 16, 2018

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?”

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