Fuchs' Endothelial Dystrophy

Overview

In Fuchs’, the inner layer of the cornea, called the endothelium, gradually start to deteriorate. This tissue plays an important role in maintaining the proper amount of fluid in the cornea. When the endothelium degenerates, fluid builds up in the cornea, causing swelling (called corneal edema) and, eventually, impaired vision.

As the disorder progresses, small blisters called epithelial bullae, can develop on the corneal surface. When these blisters burst, it is extremely painful.

Symptoms

Although an eye doctor may be able to detect signs of Fuchs' when a patient is 30-40 years old, most patients don't notice symptoms until they are 50-60 years old. There are two stages of the disease, and both eyes are typically affected.

Stage 1 (early phase): You may have hazy vision in the morning, due to fluid that builds up in your cornea during sleep. Vision typically improves as the day goes on. You might also have difficulty seeing in low light.

Stage 2 (later phase): Symptoms become more noticeable. You may have blurry or hazy vision that does not improve throughout the day. In the advanced stages of the disease, scars on the cornea can lead to significant vision loss. Additional symptoms may include:

• Sensitivity to light
• Halos
• Very blurry or cloudy vision
• Decreased night vision (difficulty driving at night)
• Decreased vision in humid eweather
• Pain in your eyes
• Small blisters on the cornea
• Gritty or sandy feeling in your eyes
• Swelling in your eyes

Potential Causes and Risk Factors

Fuchs’ dystrophy can be inherited, but it can also occur without a family history of the disease. In many cases, the cause is unknown. The disease is also slightly more common in women than men.

Mass. Eye and Ear researcher recently discovered that ultraviolet light exposure may also be a risk factor for the disease. Their work may also offer an explanation for why this disease is found in the central cornea and more common in women. Read more on our Focus blog

Diagnosis