Fuch’s Corneal Dystrophy

Fuch’s corneal dystrophy, also often referred to as just ‘Fuch’s dystrophy’, is a condition affecting the innermost layer of a part of the eye known as the cornea. This layer, called the endothelium, controls the level of fluid in the eye, pumping out any excess that could cause the cornea to swell. In patients with Fuch’s corneal dystrophy, the cells in the endothelium do not function as they should, causing the cornea to become waterlogged and cloudy. This causes the patient to experience anything from mild to severe vision problems.

The stages of Fuch’s dystrophy

Fuch’s dystrophy occurs in two stages. Early on in the condition, symptoms may be few and far between. You may find that your vision is a little hazy or blurry when you first wake up, but returns to normal throughout the day. The reason for this is that your eyes naturally retain moisture when they are closed while you sleep. However, when you wake up, the fluid starts to dry as usual.

As the condition progresses to the second stage, you will probably find that it is impossible to shift that early morning haziness and your sight remains blurry for the duration of the day. This is because the endothelium is unable to drain enough fluid from your eyes during the night, that means that there is an excess that can’t dry up as it should during the day. In some cases, tiny blisters may form in the corneal tissue, which can cause pain if they burst.

Symptoms of Fuch’s dystrophy

As the condition progresses, you may experience symptoms that include:

- Appearance of halo-like circles around lights, particularly at night

- Night vision problems

- An inability to drive at night

- Sensitivity to light

- Low vision in humid weather

- Gritty eyes

- Pain in your eyes

- Swelling in and around your eyes

- Cloudy or hazy vision

Causes of Fuch’s dystrophy

Fuch’s dystrophy occurs when the cells in the endothelium degenerate and die. Unfortunately, the exact reason as to why this happens is unknown. Some studies suggest that it is age-related, as the condition is believed to begin when patients are in their 30s or 40s. However, because symptoms are so mild in the early stages, many patients are not diagnosed until they are 50+ years of age.

Other risk factors for developing Fuch’s dystrophy include a hereditary pre-disposition, a diagnosis of diabetes and smoking. The condition also affects more women than men.

Treatment for Fuch’s dystrophy

Fuch’s dystrophy can only be diagnosed by a professional eye doctor after a comprehensive examination. If you are diagnosed with this progressive condition, our knowledgeable and reassuring team will speak to you about your treatment options. Although there is no known cure for Fuch’s dystrophy, there are treatments that we can provide that will help to correct your vision problems and alleviate any discomfort that you may be experiencing.

Non-surgical treatments

If you are still in the early stages of Fuch’s syndrome, we will likely prescribe you with medication that will help to reduce the swelling of the cells in the endothelium. This is usually administered in the form of eye drops or topical gel. We may also recommend that you consider using a hairdryer to blow warm air on your face after you first wake up. This will help to dry the surface of the cornea and reduce the likelihood of extended blurriness. Make sure that you have the hairdryer on a warm – not hot – setting, and hold it at arm’s length so that you do not burn your eyes.

Surgical treatments

If you are in the later stages of Fuch’s syndrome, surgical intervention may be the only way to improve your vision and restore your quality of life. There are two types of surgery available to treat Fuch’s dystrophy. These are:

An endothelial keratoplasty – this is where healthy endothelial cells are transplanted into your cornea, so they can effectively and successfully drain the excess fluid from your cornea.

A full corneal transplant – this is where the center of your cornea is replaced with a healthy cornea from a suitable donor. Again, the healthy cornea will have properly functioning endothelial cells, so that the fluid drains as it should.

Both surgeries can be performed under a local anesthetic, are fairly straightforward and are usually considered to be very successful. Which type of surgery is right for you will be discussed with you at your consultation appointment.