Fuchs’ Dystrophy

Many people are familiar with terms such as ‘pupil;’ the black dot in the center of the eye, and ‘iris;’ the colorful ring surrounding the pupil which helps give you your unique look! Covering both of these is the cornea—a dome-like structure which helps process light.
The inner layer of the cornea consists of ‘endothelial cells.’ A reduction in the number of endothelial cells results in the cornea becoming unusually puffy or thick. This condition is known as Fuchs’ Dystrophy. Individuals with Fuchs’ dystrophy also experience growth of droplet-shaped bumps called ‘guttata.’ Guttae occur in the layer of tissue underneath the endothelial cells in a location known as the Descemet’s membrane. Such changes to corneal cells may result in the cornea losing its transparency and clarity. Fuchs’ dystrophy is a progressive disease that usually occurs in patients over the age of 40. Studies have shown that the disease is inherited.
Symptoms of Fuchs’ dystrophy usually develop over two stages. Stage 1 is marked by an absence of symptoms or symptoms which are mild. Patients in stage 1 report that their vision is worse in the morning then begins to clear as the day progresses. This is due to a buildup of moisture in the eyes while sleeping. As the eyes remain open during the day, the moisture is evaporated out of the cornea resulting in improved vision.
Fuchs’ dystrophy progresses to stage 2 when vision no longer clears up as the day goes on. Stage 2 patients may experience pain and sensitivity to light. Changes in climate such as high humidity can cause these symptoms to worsen. Scarring at the center of the cornea may develop over time. Scarring may cause discomfort and reduce vision. It may take from 10 to 20 years for Fuchs’ dystrophy to progress from stage 1 to stage 2. In rare situations, a corneal transplant surgery may be necessary to correct significant vision loss.
Treatment for Fuchs’ dystrophy varies based on the condition of individual patients. Stage 1 treatments include application of eyedrops to lessen swelling of corneal cells. The use of a hair dryer at range to help dry the surface of the cornea may relieve symptoms as well. Stage 2 patients may need a therapeutic ‘bandage’ lens to relieve discomfort.
If you experience loss in quality of vision or discomfort, schedule an appointment with your ophthalmologist for a comprehensive evaluation. It is important to schedule routine eye exams to keep on top of your vision health!