Fuchs’ Dystrophy, also referred to as Fuchs’ Endothelial Corneal Dystrophy (FECD), is a condition wherein fluid fills up in the clear tissue in the front known as the cornea. This genetic eye defect was first discovered in patients in the year 1910, by the renowned Austrian ophthalmologist Ernst Fuchs and the disorder is hence named after him, as Fuchs Dystrophy.

Due to obstruction of the corneal layer in either one or both eyes, Fuchs’ dystrophy prompts glare, blurry vision and pain, discomfort in the eyes and the region surrounding them. This eye ailment begins to develop in people in their 30s and 40s, but symptoms arise prominently only later on, in the 50s and 60s. Fuchs’ dystrophy occurs more often in women than in men, with gradual decline in eyesight as the symptoms worsen with age, such as in AMD – age-related macular degeneration.

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Fuchs' Dystrophy

Causes Of Fuchs’ Dystrophy:

Fuchs’ dystrophy is prompted by inherited genetic defects in the corneal endothelial cells passed on among close family members. The severity of symptoms however varies widely among closely related people, from being very mild with relatively healthy vision to quite severe with hampered eyesight.

The genetic flaws in the endothelial tissues of the cornea result in accumulation of fluid within the thin outer layers and fluid build-up and swelling i.e. edema in the eyes. The corneal layer hence becomes very thick and leads to hazy distorted vision, since the regular functional abilities of the cornea to maintain optimal fluid balance in the eye sockets is impeded owing to endothelial cell damage or defects.

Symptoms:

Initially, the signs of Fuchs’ dystrophy are subtle and might present only in one eye, with slight discomfort and minor difficulty focusing on objects clearly. However, as the corneal layers deteriorate with age, Fuchs’ dystrophy induces prominent indications in both eyes, including:

  • Cloudy vision, with poor clarity in viewing objects farther away or small text documents, like in myopia
  • Exacerbation of eye pain and hazy vision in the morning right after waking up
  • Incapability to adjust to different intensities of light, facing issues of glare in bright and dim surroundings
  • Viewing odd white rings i.e. halos around objects owing to lack of focus and blurring
  • Formation of small sore blisters in the cornea triggering eye pain and rigidity

Diagnosis:

Doctors specializing in eye ailments – optometrists and ophthalmologists, enquire if the patient has considerable eyesight problems and about any other abnormal signs they may have encountered. Then, a thorough external examination of both eyes is conducted, to identify any aberrant modifications in the corneas.

Furthermore, the medical expert utilizes specialized apparatus to capture detailed photographs of both the eyes, to measure the amount of endothelial cells present within the corneas. An eye pressure test or tonometry test which is part of an eye exam is also performed, to calculate intraocular pressure inside the eyes, to rule out the possibility of glaucoma.

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Treatment:

Treatment for Fuchs’s dystrophy depends on the severity of symptoms. If eye pain is mild and there is no significant obstruction to vision, then the doctor prescribes eye drops and ointments to be applied directly on the eyes to soothe aching and swelling.

Nevertheless, if the endothelial cells in the corneas endure massive damage and deterioration, then the healthcare professional advises the patient to undergo surgery. The procedures involved are either a full corneal transplant to replace the entire cornea in both eyes or endothelial keratoplasty, in which healthy, functional endothelial cells are transplanted onto the cornea to replace damaged tissues. In this manner, the symptoms of cloudy vision with blurring and pain are alleviated in the patient and normal vision is restored.