Fuchs’ Dystrophy

What is Fuchs’ Dystrophy?

Fuchs’ dystrophy also referred to as Fuchs’ corneal endothelial dystrophy (FCED) is an eye disease which deteriorates the inner layer cells of the cornea. Due to this clear layer (cornea) swells up, and vision becomes cloudy and hazy. It’s a hereditary disease that often shows traits after the age of 50. The cellular inner layer of cornea named ‘endothelium’ basically drains the fluid to keep it clear and sterile. However, when inner cells die off, fluid called edema starts accumulating within the cornea resulting in corneal swelling.

Causes

Inherited genetic traits mainly cause Fuchs’ Dystrophy. It means if a family has a history of FD, there are more than 50% chances of it occurring in other family members. Endothelial tissue damage of cornea leads to this disorder and it is more common in women. Other factors include:

  • Age (50-60 years)
  • Smoking
  • Diabetes

 Symptoms

  • Blurred or cloudy vision in the morning (vision improves during the day)
  • Gritty or sandy sensation in the eyes
  • Highly sensitive to the bright light
  • Eye pain (generating from minute blisters of corneal cells)
  • Glare
  • Difficulty in seeing at night
  • Irregular corneal guttae

Diagnosis

  • Corneal pressure test: Doctors measure the corneal pressure with special equipment through the process of pachymetry.
  • Staging: Doctors test the stage of patient’s condition with an optical microscope. With the help of slit lamp, they study the endothelial layer of cells to recognize the irregular guttae (bumps) on the tissue layer.
  • Corneal thickness: Analyzing the corneal thickness is the best part of a physical examination.
  • Corneal cell count: Generally doctors use this technique of counting number, shape, and size of the cells that form the back lining of the cornea. It helps in the assessment of this disease at the initial stages.

As per the diagnostic norms, early detection is very crucial and beneficial as it becomes easy to control the rupture stage of epithelial bullae that leads to corneal abrasions.

Treatment

Penetrating Keratoplasty (PK)

It is a surgery in which damaged cornea gets removed and healthy tissues are grafted. It is a conventional way of a corneal transplant.

Descemet’s Membrane Endothelial Keratoplasty (DMEK)

A new popular surgery, the specifically damaged tissues of the endothelium are removed with a small incision, and donor tissues get flattened. This process is pioneering the success rate these days.

Femtosecond laser-assisted Descemet Stripping Endothelial Keratoplasty (FS-DSEK)

DMEK’s advanced form of surgery is Femtosecond laser-assisted Descemet Stripping Endothelial Keratoplasty (FS-DSEK). For very initial stages, doctors recommend glaucoma eye drops, special medicated salt solutions, soft contact lenses, glasses or photochromic lenses.

There are non-surgical treatments as well as self-care strategies that help in relieving the symptoms. They include:

  • Eye Medication: Ointments or Eye drops help in reduction of the amount of fluid inside the cornea.
  • Soft contact lenses: Relieves pain in the eye

Prognosis and Precaution

Sometimes Fuchs’ dystrophy doesn’t need any treatment as it does not show its fatal effect but causes vision loss in many cases. If a person gets a hint of this disorder, he/she should visit an optometrist immediately. If a patient has a cataract or undergone cataract surgery, he/she needs to take extra precaution.

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