Fuchs’ (fooks) dystrophy

DEFINITION

Fuchs’ (fooks) dystrophy affects the cornea — the clear front window of your eye. This disorder causes swelling in the cornea that can lead to glare, cloudy vision and eye discomfort.

Fuchs’ dystrophy usually affects both eyes and can cause your vision to gradually worsen over many years. But most people with Fuchs’ dystrophy have a mild type and don’t notice much change in their eyesight.

Some medications and self-care steps may help relieve your Fuchs’ dystrophy signs and symptoms. But when the disorder is advanced and you’ve lost vision, the only way to restore vision is with cornea transplant surgery.

CAUSES

Normally, the cells lining the inside of the cornea (endothelial cells) help maintain a healthy balance of fluids within the cornea. Healthy endothelial cells prevent the cornea from swelling and help keep the cornea clear. But with Fuchs’ dystrophy, the endothelial cells slowly die off, and probably do not function correctly, resulting in fluid buildup within the cornea (swelling or edema). This causes corneal thickening and blurred vision.

Fuchs’ dystrophy can be inherited. The genetic basis of the disease is complex — family members can be affected to very variable degrees, and sometimes not at all.

SYMPTOMS

As the disease progresses, Fuchs’ dystrophy symptoms usually affect both eyes and may include:

• Glare, which is an early symptom and reduces contrast perception or affects vision in low light.
• Blurred vision, which occurs in the morning after awakening and gradually improves during the day. As the disease progresses, vision can take longer to improve or may not improve.
• Distorted vision, sensitivity to light, difficulty seeing at night and seeing halos around light
• Painful, tiny blisters on the surface of your cornea
• A cornea that looks cloudy or hazy

When your ophthalmologist examines your cornea, he or she looks for:

• Irregular bumps on the back surface of the cornea (guttae)
• Corneal swelling
• Corneal haze
• Thickening of the cornea, measured by a special instrument (typically an ultrasound)

When to see a doctor

If you experience some of these signs and symptoms, and especially if they get worse over time, see an eye specialist (ophthalmologist). If symptoms develop suddenly, call an ophthalmologist for an urgent appointment. Other eye conditions that cause the same symptoms as Fuchs’ dystrophy also require prompt treatment.