Fuchs Dystrophy

In the early stage, you might not have any symptoms. If you do have an early symptom, it might be that your vision is blurred in the morning but gets better as the day goes on.

Later, Fuchs’ endothelial dystrophy symptoms may include:

• Poor night vision, like seeing a glare and halos around lights
• Difficulty seeing on rainy days
• Problems seeing objects against a background (poor contrast sensitivity)
• Sensitivity to bright light
• Feeling like you have something like sand or dirt in your eyes
• Eye pain from blisters that form on your cornea and then break open
• Scarring that affects your central cornea first

How doctors diagnose Fuchs’ dystrophy

An eye care specialist will begin by taking a medical history, asking questions about your symptoms and doing a thorough eye exam.

Your provider will be able to see things in your eye exam that will point to a diagnosis of Fuchs’ dystrophy. These include:

• Thickening of certain membranes
• Changes in the way your endothelium looks
• Bumps called guttae on the inside of your cornea

Tests to diagnose Fuchs’ corneal dystrophy

Your provider may use the following tests to diagnose Fuchs’ dystrophy:

• Microscopy. These types of exams use microscopes to make diagnoses. Examples include a slit lamp and a confocal/specular microscope.
• Pachymetry. This painless test measures how thick your cornea is.
• Optical coherence tomography. This is a noninvasive imaging method that uses reflected light to create pictures of the back of your eye.

A healthcare provider can treat Fuchs’ endothelial dystrophy, but they can’t cure it. Your provider may choose observation during the early stage. Other Fuchs’ dystrophy treatments may include:

• Ointments and eye drops. For mild symptoms, these medications reduce swelling of your cells by helping to dry up excess fluid. The improvement is usually temporary.
• Handheld hair dryer. Using a handheld dryer to blow warm air at your face can help the fluid dry up. This may be helpful for morning blur.
• Corneal transplant. When Fuchs’ starts to limit your vision, surgery is the definitive treatment. You may get a partial corneal transplant (endothelial keratoplasty) or a full corneal transplant.
• Descemet’s stripping only (DSO). A newer procedure involves stripping away the diseased cells in the center to allow your own, healthier cells from the sides to replace them.

What can I expect if I have Fuchs’ dystrophy?

Depending on how severe it is, Fuchs’ dystrophy may cause extreme pain, low vision or blindness if you don’t seek treatment.

With treatment, your expected outcome is much better. Your vision may improve to 20/20 within days of surgery (with glasses). That’s why it’s important to work with your provider to find the right treatment for you.

How can I prevent Fuchs’ dystrophy?

There’s currently no way to prevent Fuchs’ corneal dystrophy. But you can help yourself by quitting smoking if you do smoke. If you have diabetes, work with your healthcare provider to manage your blood sugar levels.