Fuchs' Dystrophy - Symptoms, Causes & Treatment

6 sources cited
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What Is Fuchs’ Dystrophy?

Fuchs' dystrophy is a disease of the cornea (clear outer part of the eye). It results from endothelial cells gradually deteriorating, leading to corneal swelling and fluid buildup. 

Because the disease progresses slowly, it can take decades for vision problems to develop. Late-onset Fuchs' endothelial dystrophy affects 4% of people over 40 in the United States.2 

Fuchs’ dystrophy is an inherited condition. However, spontaneous gene mutations can also cause people with no family history of Fuchs’ to develop the disease. It affects women four times more than men.2 

Can You Go Blind from Corneal Dystrophy?

Vision impairment from Fuchs' dystrophy gradually worsens over time. Without treatment, severe cases can lead to corneal blindness. A corneal transplant may be necessary.

Fuchs’ dystrophy is the leading motive for corneal transplantation worldwide.4 

Symptoms of Fuchs’ Dystrophy

Fuchs' dystrophy is broken down into an early stage and a later stage. 

Since Fuchs’ dystrophy progresses slowly, you might not know you have the condition until later in life when your vision starts to change. 

In the early stage of Fuchs' dystrophy, you may wake up with hazy or blurry vision, but it improves throughout the day. 

Symptoms of later stage Fuchs’ dystrophy include:

  • The feeling of grit or sand in your eyes
  • Light sensitivity
  • Hazy and blurred vision 
  • Colored halos around light
  • Vision gets worse throughout the day
  • Eye pain

Causes and Risk Factors of Fuchs’ Dystrophy

This disease is caused by deteriorating endothelial cells of the cornea. Since these cells are responsible for fluid balance, the lack of a healthy endothelial layer leads to fluid buildup, inflammation, and corneal thickening. Over time, symptoms lead to a decrease in visual acuity.

The most common cause of Fuchs' dystrophy is genetics. People with the gene that causes 

Fuchs' dystrophy have a 50% chance of passing it to their children.5 

Other risk factors include:

  • Smoking 
  • High body mass index
  • Diabetes

Studies have found that people who smoke 20 packs of cigarettes a year double their chance of developing corneal disease.5

How is Fuchs’ Dystrophy Diagnosed?

Fuchs’ dystrophy is usually discovered during a routine comprehensive eye exam with an ophthalmologist. 

During the exam, an eye doctor will:

  • Obtain a family and medical history
  • Ask about symptoms 
  • Use pachymetry to measure corneal thickness
  • Check eye pressure for signs of glaucoma
  • Use a slit lamp to examine the eye for signs of corneal guttae (tiny blisters)
  • Count the corneal endothelial cells using a special camera

See an eye doctor if you have any changes in vision or symptoms of Fuch's dystrophy. 

Treatment for Fuchs’ Dystrophy

While there is no cure for Fuchs’ dystrophy, treatment options are available to decrease swelling and improve vision. 

A licensed ophthalmologist will create a treatment plan based on the severity of symptoms and how the disease affects the corneal endothelium. 

Early-stage treatment may include nonsurgical interventions, such as:

  • Medicated eye drops or ointment to decrease swelling
  • Using a hair dryer at arm's length to dry the cornea surface (be careful to use a very low heat or cool setting)
  • Therapeutic soft contact lenses 
  • Sodium chloride eye drops

In late-stage Fuchs' dystrophy, vision problems may affect the quality of life, and a corneal transplant may be needed. There are two types of corneal transplants, including:

  • A full-thickness corneal transplant replaces the center of your cornea with a healthy donor 
  • Endothelial keratoplasty (EK) transplants healthy endothelial cells into the cornea

Complications from treating Fuchs’ dystrophy can include:

Summary

Fuchs' dystrophy is a slowly progressing cornea disease caused by the deterioration of endothelial cells, which leads to swelling and fluid buildup. Genetics is the most common cause of Fuchs' dystrophy. It is more prevalent in women than men. 

While there is no cure for Fuchs' dystrophy, early detection can prevent vision problems with nonsurgical treatment, including medicated eye drops and ointment. A corneal transplant may be necessary if vision changes affect the quality of life. 

6 Cited Research Articles
  1. Boyd, K. “What is fuchs' dystrophy?” American Academy of Ophthalmology, 2021. 
  2. National Library of Medicine. “Fuchs endothelial dystrophy.” medlineplus.gov, n.d.
  3. Mount Sinai. “Fuchs dystrophy.” mountsinai.org, n.d.
  4. Mattahei, M., et al. “Fuchs endothelial corneal dystrophy: clinical, genetic, pathophysiologic, and therapeutic aspects.” Annual Review of Vision Science, 2019. 
  5. Ayres, B., et al. “Fuchs’ endothelial dystrophy.” American Academy of Ophthalmology, 2022.
  6. Zhang, X., et al. “Association of smoking and other risk factors with fuchs' endothelial corneal dystrophy severity and corneal thickness.” Investigative Ophthalmology & Visual Science, 2013.
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