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Fuchs’ Dystrophy

Fuchs’ dystrophy is by definition a bilateral inherited disease that affects the cornea.  The cornea is the front part of the eye that people put their contact lenses on and covers the colored part of the eye (iris).  The cornea is responsible for focusing light rays into the back of the eye.

There are five layers in the cornea:

  • Epithelium – surface layer
  • Bowman’s membrane
  • Stroma – is responsible for most of the cornea’s thickness
  • Descemet’s membrane
  • Endothelium – inside layer of the cornea

In Fuchs dystrophy, cells in the endothelium are reduced in number.  Endothelial cells do not regenerate or replace themselves.  Endothelial cells are responsible for keeping the cornea clear.  If the cornea loses too many endothelial cells, the cornea will begin to swell and lead to loss of vision.

Symptoms of Fuchs’ dystrophy include hazy or cloudy vision that develops in stages. In the first stage the cornea swells in the morning which may lead to be hazy vision that clears up during the day. Once the disease has progressed to a more advanced stage, vision no longer clears.   Eventually, you may experience pain and sensitivity to light.

In its early stage, Fuchs’ dystrophy is treated with saline eye drops to pull excess fluid from the cornea or with a hairdryer to help dry the surface of the cornea. As Fuchs’ dystrophy advances, you may be given a therapeutic bandage contact lens to lessen your discomfort.

If vision loss begins to interfere with your life in the latter stages of the disease, a partial corneal transplant or DLEK may be performed.  If you have Fuchs’ dystrophy and are considering cataract surgery, there is an additional risk that swelling may persist after surgery and a corneal transplant may be required

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