Fuchs' dystrophy is an eye disease that is the leading cause of corneal transplants in the U.S. It is a slowly progressing disease; doctors can sometimes see the first indications of the disease in a patient's 30s or 40s, but vision impairment doesn't usually start until her 50s or 60s.
What Is It?
Fuchs' dystrophy is also called Fuchs' endothelial dystrophy or Fuchs' corneal dystrophy, because it affects the endothelium, which is a thin layer of cells lining the inner side of the cornea. These cells are responsible for helping to pump extra fluid out of the cornea. In a Fuchs' dystrophy patient, these cells start dying, which results in a build-up of fluid, which in turn causes swelling and clouding of the cornea.
As the disease progresses, small blisters may form in the endothelium; these blisters may get bigger and break, which causes eye pain.
The cause of Fuchs' dystrophy is unknown, though it can be inherited; if either parent has the condition, their child has a 50 per cent chance of getting it. It affects slightly more women than men.
Symptoms of Fuchs' dystrophy include eye pain, foggy vision, sensitivity to light or seeing coloured halos around lights, and worsening vision throughout the day. As the disease progresses, complications such as vision loss or frequent, severe pain can also develop.
A slit-lamp examination can help a doctor determine if a patient has Fuchs' dystrophy. This examination uses a low-power microscope and a thin beam of high-intensity light to look at the structures of the front of the eye.
Other tests, such as pachymetry (measuring the thickness of the cornea), specular microscope examination (inspecting the endothelial cells) and a vision test can help determine the progression of the disease.
There are treatments to relieve the symptoms of Fuchs' dystrophy, such as eye drops that draw the fluid out of the cornea or contacts or surgery to cover sores that may develop on the surface of the cornea.
The only cure, however, is corneal transplant, either replacing the entire cornea or, in the case of deep lamellar keratoplasty, using donor tissue to replace just the inner layers of the cornea. DLK may be a better option for some patients, as it requires no stitches and has a faster recovery time.