Fuchs’ corneal dystrophy is a disorder of the cornea in which fluid builds up causing the cornea to swell and thicken. It also causes bumps to form on the cornea. This condition can lead to glare, blurred or cloudy vision, and eye discomfort.
It usually affects both eyes and gradually worsens. The disease typically starts at around age 30 or 40, but some people don’t develop symptoms until they reach 50 or 60.
Causes Fuchs’ Corneal Dystrophy
The layer of cells (endothelium cells) that are responsible for maintaining proper fluid levels in the cornea deteriorate and no longer function properly. One reason the cornea is normally clear and transparent is due to healthy endothelial cells limiting extra water accumulation in the cornea. When enough of the cells have deteriorated, the symptoms of fluid buildup and corneal swelling begins. The swelling causes the cornea to become cloudy, blurring vision. The condition is usually inherited.
At the beginning, the disorder causes vision to be hazy in the morning because of fluid buildup during sleep when the eyes are closed and the symptoms gradually improve throughout the day as the excess fluid in the cornea dries.
In the advanced stage, the periods of cloudy, hazy vision, and eye discomfort last longer and longer and can get to the stage where they don’t subside.
- Blurred or cloudy vision that fluctuates with worse symptoms in the morning and gradual improvement during the day
- Glare and seeing halos around lights
- Pain or grittiness from the tiny blisters that form on the surface of the cornea
If you have these symptoms and especially if they worsen, see an eye doctor. If these symptoms develop suddenly, call for an urgent appointment. Other eye conditions that cause these same symptoms also require prompt treatment.
The diagnosis of Fuchs’ corneal dystrophy is made after examining the eye with an optical microscope to look for irregular bumps on the inside surface of the cornea and to assess cornea swelling. Cornea thickness may also be measured and sometimes an examination of the number, shape, and size of the endothelium cells that line the back of the cornea.
Treatment for Fuchs’ Corneal Dystrophy
There is no cure for Fuchs’ dystrophy, but some nonsurgical treatments may help in the early stages of the disorder, such as eye drops or ointments to ease the corneal swelling.
In the late stages of Fuchs’ dystrophy, you may need a cornea transplant. There are two types:
A partial cornea transplant in which the inner layers of your cornea are replaced with healthy donor tissue. This method uses only a few sutures or no sutures, which helps speed recovery. This method makes up about 90% of all cornea transplants in the United States.
A full cornea transplant replaces the center two-thirds of the cornea with donor tissue. This type of surgery takes longer to recover from and has a higher risk of rejection and injury.
Some people have 20/20 vision, with glasses, just days after surgery, but generally the return to normal vision takes a few weeks or months.
Rejection of the donor tissue occurs in about 10% of cornea transplants.
Signs of rejection are:
- Eye pain
- Extreme sensitivity to light
- Eye redness
- Cloudy or hazy vision
Report these symptoms to your surgeon and you can be given medication that might prevent a rejection. Cornea transplant rejection can be reversed in about 9 out of 10 cases if detected early enough.
For patients prone to reject donor corneal tissue, artificial corneas are also available, and they have improved greatly over the past 40 years. Research and development to further improve them is ongoing.