Fuchs' Dystrophy

Fuchs’ dystrophy is a disorder of the corneal endothelium. In a healthy eye, the corneal endothelium functions as a pump; the endothelial cells work to rid the cornea of excess water, keeping the cornea dehydrated and crystal clear. If water leaks into the cornea, the cornea becomes cloudy and vision decreases. Unlike many other cells in the body, we cannot grow new corneal endothelial cells. As we age, we slowly lose some endothelial cells, but in general, most people retain enough cells so that the endothelium functions properly.

For individuals who have fuchs’ dystrophy, the corneal endothelium weakens and doesn’t function adequately, resulting in the ultimate loss of endothelial cells. The endothelial cells die off much faster in fuchs’ dystrophy than they do with the natural aging process.

What Types of Problems Occur in People Who Have Fuchs’ Dystrophy?

Early in the disease there are enough endothelial cells to maintain clear vision. As more endothelial cells deteriorate, the cornea may lose its transparency and vision becomes cloudy. When the cornea becomes so swollen from excess water entering the epithelial layer, tiny blisters, or “bullae” form on the outer surface of the eye. When these blisters rupture, this causes pain and a further decrease in vision. This condition is called “bullous keratopathy.”

How is Fuch’s Dystrophy Diagnosed?

Fuch’s Dystrophy DiagnosedA Hawaii Eye Institute specialist uses a high magnification microscope called a slit lamp to examine the health of the corneal endothelium. Unhealthy endothelial cells create tiny bumps called “guttata.” When there are many guttata, the corneal endothelium is described as having a “beaten metal appearance.” Other corneal diagnostic testing may also be used.

What Treatments are Available for Fuchs’ Dystrophy?

Initially, eye-drops and ointments can be used to dehydrate the cornea. Bandage contact lenses can be used to minimize the discomfort from ruptured blisters. Eventually, if the disease becomes severe enough, a corneal transplant may be necessary to restore sight.

To learn more about Fuchs’ Dystrophy treatment, contact us at Hawaii Eye Institute today.


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