Corneal Dystrophy

What is Fuchs’ Dystrophy?

Fuchs’ dystrophy is a relatively common corneal dystrophy. The cornea has three layers. The bulk of the cornea is called the stroma. The stroma is covered externally by an epithelium, endothelium which is several layers thick, and the stroma is lined internally by the endothelium, which is one single layer thick.

What are the symptoms of Fuchs’ dystrophy?

The endothelium of the cornea is the primary area affected in Fuchs’ corneal dystrophy. When the endothelium is unhealthy, the cells die and do not regenerate. They also leave dots, called guttata, on the inside of the cornea. Guttata is often the first sign of Fuchs’ dystrophy. Although guttata can cause some glare and reduce the quality of vision, they do not in themselves cause serious vision loss.

In the late stages of Fuchs’ dystrophy, the corneal endothelial cells lose their ability to perform their primary purpose, pumping fluid from the stroma. As the endothelial cells die and this ability to pump fluid from the stroma is lost, the stroma accumulates fluid. This condition is called corneal stroma edema. As this edema develops, the cornea becomes thicker because of the fluid. It also becomes more hazy, like a steamed-up window. This results in a fairly significant decrease in vision. Many patients require penetrating keratoplasty (a corneal transplant) in order to recover their vision.

What can happen if the edema is not treated?

Without penetrating keratoplasty, patients with corneal stromal edema can develop epithelial edema. Epithelial edema can lead to microscopic blisters, and occasionally large blisters, on the cornea. The large blisters can become painful and repeatedly erode the eye. In this situation, corneal transplantation is helpful, as it can relieve the pain the patient is suffering.

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I want to know how a Fuchs’ Dystrophy is treated.

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