Fuchs’ Dystrophy

Medically reviewed by Ann Marie Griff, OD on September 7, 2017Written by Kristeen Cherney on September 7, 2017

What is Fuchs’ dystrophy?

Fuchs’ dystrophy is a type of eye disease that affects the cornea. Your cornea is the dome-shaped outer layer of your eye that helps you see.

Fuchs’ dystrophy can cause your vision to decrease over time. Unlike other types of dystrophy, this type affects both of your eyes. However, vision in one eye may be worse than the other.

This eye disorder may go unnoticed for years before your vision worsens. The only way to help Fuchs’ dystrophy is through treatment. In the case of vision loss, you may need surgery.

What are the symptoms of Fuchs’ dystrophy?

There are two stages of Fuchs’ dystrophy. This type of corneal dystrophy can be progressive, so you might experience worsening symptoms on a gradual basis.

In the first stage, you may have blurry vision that’s worse upon waking up due to fluid that builds up in your cornea while you sleep. You might also have difficulty seeing in low light.

The second stage causes more noticeable symptoms because fluid buildup or swelling doesn’t improve during the day. As Fuchs’ dystrophy progresses, you may experience:

  • sensitivity to light
  • cloudy vision
  • night vision problems
  • an inability to drive at night
  • pain in your eyes
  • a gritty-like feeling in both eyes
  • swelling
  • low vision in humid weather
  • the appearance of halo-like circles around lights, especially at night

Additionally, Fuchs’ dystrophy may cause some physical symptoms that others might be able to see on your eyes. These include blisters and cloudiness on the cornea. Sometimes corneal blisters can pop, causing more pain and discomfort.

What causes Fuchs’ dystrophy?

Fuchs’ dystrophy is caused by the destruction of endothelium cells in the cornea. The precise cause of this cellular destruction isn’t known. Your endothelium cells are responsible for balancing fluids in your cornea. Without them, your cornea swells because of the fluid buildup. Eventually, your vision is affected because the cornea thickens up.

Fuchs’ dystrophy develops slowly. In fact, the disease usually hits during your 30s or 40s, but you may not be able to tell because the symptoms are minimal during the first stage. In fact, you may not notice any significant symptoms until you’re in your 50s.

This condition may be genetic. If someone in your family has it, your risk for developing the disorder is greater.

According to the National Eye Institute, Fuchs’ dystrophy affects more women than men. You’re also at a greater risk if you have diabetes. Smoking is an additional risk factor.

How is Fuchs’ dystrophy diagnosed?

Fuchs’ dystrophy is diagnosed by an eye doctor called an ophthalmologist or optometrist. They’ll ask you questions about the symptoms you’ve been experiencing. During the exam, they’ll examine your eyes to look for signs of changes in your cornea.

Your doctor may also take a specialized photograph of your eyes. This is conducted to measure the amount of endothelium cells in the cornea.

An eye pressure test may be used to rule out other eye diseases, such as glaucoma.

Signs and symptoms of Fuchs’ dystrophy can be difficult to detect at first. As a rule of thumb, you should always see an eye doctor if you experience vision changes or discomfort in your eyes.

If you wear contacts or eyeglasses, you should already see an eye doctor on a regular basis. Make a special appointment if you experience any possible symptoms of corneal dystrophy.

Fuchs’ dystrophy with cataracts

Cataracts are a natural part of aging. A cataract causes a gradual clouding of the eye lens, which may be corrected by cataract surgery.

It’s also possible to develop cataracts on top of Fuchs’ dystrophy. If this happens, you may need to have two types of surgeries at once: cataract removal and corneal transplant. This is because cataract surgery can damage the already-delicate endothelial cells that are characteristic of Fuchs’.

Can Fuchs’ dystrophy cause other conditions to develop?

Treatment for Fuchs’ dystrophy can help slow down the rate of corneal degeneration. Without treatment, however, your cornea may be damaged. Depending on the level of deterioration, your doctor might recommend a corneal transplant.

How is Fuchs’ dystrophy treated?

The early stage of Fuchs’ dystrophy is treated with prescription eye drops or ointments to reduce pain and swelling. Your doctor may also recommend soft contact lenses as needed.

Significant corneal scarring may warrant a transplant. There are two options: a full corneal transplant or an endothelial keratoplasty (EK). With a full corneal transplant, your doctor will replace your cornea with that of a donor. An EK involves transplanting endothelial cells in the cornea to replace the damaged ones.

Home treatments

There are few natural treatments available for Fuchs’ dystrophy because there’s no way to naturally encourage endothelial cell growth. You can, however, take steps to minimize symptoms. Blow-drying your eyes with a hair dryer set on low a few times per day can keep your cornea dry. Over-the-counter sodium chloride eye drops can also help.

What is the outlook of Fuchs’ dystrophy?

Fuchs’ dystrophy is a progressive disease. It’s best to catch the disease in its earliest stages to prevent vision problems and to control any eye discomfort.

The trouble is that you may not know you have Fuchs’ dystrophy until it causes more noticeable symptoms. Getting a regular eye exam can help catch eye diseases like Fuchs’ before they progress.

There is no cure for this corneal disease. The goal of treatment is to help control Fuchs’ dystrophy’s effects on your vision and eye comfort.

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