Fuchs Endothelial Dystrophy

Fuchs Endothelial Dystrophy is a condition where the cells on the back of the cornea drop out. These endothelial cells are important for keeping the cornea clear and as a result of loss, the cornea fills with fluid which in turns affects corneal transparency. There are treatment options available.
Centre for Sight consultant Marcela Espinosa-Lagana during a consultation with a patient

What is Fuchs Endothelial Dystrophy?

Fuchs Endothelial Dystrophy is a is a slowly progressing corneal disease that usually affects both eyes. A relatively common, progressive eye condition, Fuch’s dystrophy affects the innermost layer of cells in the cornea, known as endothelial cells.

Endothelial cells are responsible for maintaining corneal clarity by pumping out excess fluid, but in Fuch’s dystrophy, these cells gradually deteriorate. This leads to a buildup of fluid, corneal swelling, and blurred vision. Fuchs is a hereditary condition, meaning it’s passed down in families and if a parent has the condition, you are more likely to have it.

Fuchs Dystrophy typically affects people over the age of 50, although it can occasionally present earlier. Although doctors can often see early signs of the condition in people in their 30s and 40s, the disease rarely affects vision until people reach their 50s and 60s. The condition is slightly more common in women than in men.

Centre for Sight What are the Symptoms of Fuchs' Endothelial Dystrophy? couple walking through woods

What are the Symptoms of Fuchs Endothelial Dystrophy?

As with Fuchs dystrophy the cells on the innermost layer of the cornea drop out, and these cells are responsible for pumping the water out of the cornea, a main symptom is swelling. Without these cells, called endothelial cells, the cornea fills up with water and swells.

The swelling is particularly bad upon waking because having closed eyelids during sleep prevents evaporation of fluid from the cornea. Symptoms are therefore worse first thing and vision clears after a few hours. This duration until the vision clears increases as the disease progresses. Eventually vision does not recover and a corneal transplant is required.

In the early stages, symptoms of Fuchs Dystrophy may be subtle or intermittent, but as the condition progresses, they can become more noticeable. Common symptoms include:

  • Blurred or cloudy vision, especially in the morning
  • Glare and light sensitivity
  • Seeing halos around lights
  • Eye discomfort or a gritty sensation
  • Progressive worsening of vision over time

As the disease advances, the swelling can become constant and may lead to scarring of the cornea.

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Treatment for Fuchs Endothelial Dystrophy

Treatment options for Fuchs Dystrophy depend on the severity of the disease:

  • Early Stage: In mild cases, vision may improve during the day as corneal swelling reduces. Saline eye drops (hypertonic solutions) may help draw out excess fluid and reduce morning blurriness.
  • Advanced Stage: When vision becomes significantly impaired or persistent corneal swelling develops, surgical intervention may be recommended. At Centre for Sight, we offer advanced corneal transplant techniques including:
    • DSAEK (Descemet’s Stripping Automated Endothelial Keratoplasty)

A Descemet’s Stripping Automated Endothelial Keratoplasty is a small incision procedure that results in rapid visual rehabilitation. This minimally invasive procedure involves replacing the damaged inner corneal layer with healthy donor tissue, allowing faster recovery and better visual outcomes compared to traditional full-thickness corneal transplants, which involves removal and replacement of the whole cornea.

At Centre for Sight our area of special expertise is the Cornea. To read more about the procedure, you can visit our DSAEK Treatment Page.

Fuchs Dystrophy FAQs

Is Fuchs Endothelial Dystrophy hereditary?

Yes, it often runs in families. If a parent has the condition, their children may be at increased risk of developing it.

Can both eyes be affected?

Yes, Fuchs Dystrophy usually affects both eyes, although one eye may be more severely affected than the other initially.

When should I seek help for Fuchs Endothelial Dystrophy?

If you notice persistent blurry vision, especially in the mornings, or experience glare and discomfort, it’s important to schedule a comprehensive eye examination. Early diagnosis can lead to better management and outcomes.

Will I go blind from Fuchs’?

While Fuchs can significantly affect vision, modern treatments are highly effective. With the right care and, when necessary, surgical treatment, most patients regain excellent vision and quality of life. To find out more about treatment, visit our DSAEK Treatment Page.