Fuchs’ Endothelial Dystrophy: Causes, Symptoms & Treatment

Fuchs’ Endothelial Dystrophy: Causes, Symptoms & Treatment

Fuchs’ Endothelial Dystrophy is a progressive eye condition that affects the innermost layer of the cornea, known as the endothelium. These tiny cells are responsible for keeping the cornea clear by pumping out extra fluid. When these cells begin to weaken or die, the cornea starts to retain fluid and becomes swollen, cloudy, and uncomfortable. This gradually leads to blurred vision, glare, and in advanced stages, severe visual loss.

This disorder is commonly seen in adults after the age of 50, but early signs can appear much earlier. Early diagnosis and timely treatment can help preserve clear vision and prevent complications.

Causes of Fuchs’ Endothelial Dystrophy

Although the exact cause is not always known, several factors increase the risk:

1. Genetics:   The condition often runs in families. If your parents or siblings have Fuchs’ Dystrophy, your chances may be higher.

2. Aging:  The condition becomes more noticeable after the age of 40 or 50 because endothelial cells naturally decrease with age.

3. Eye Surgeries:  People who have undergone multiple eye surgeries, especially cataract surgery, may have increased stress on endothelial cells.

4. Underlying Corneal Weakness:  Some individuals naturally have a lower number of endothelial cells, making them more prone to swelling.

Symptoms of Fuchs’ Dystrophy

Symptoms usually progress slowly over several years. Common signs include:

• Blurred or foggy vision, especially in the morning
• Halos or glare around lights
• Sensitivity to light
• Fluctuating vision throughout the day
• Eye discomfort or foreign body sensation
• Reduced night vision

As the condition advances, tiny blisters may form on the cornea, causing pain or irritation.

How Fuchs’ Dystrophy Is Diagnosed

Proper diagnosis requires eye specialists who can evaluate the cornea in detail. Common tests include:

• Specular Microscopy – Measures endothelial cell count
• Pachymetry – Checks corneal thickness
• OCT Scan – Identifies corneal swelling and structural changes
• Slit Lamp Examination – Detects guttae (small bumps) on the cornea

These tests help understand the severity of the condition and guide the best treatment plan.

Treatment Options for Fuchs’ Endothelial Dystrophy

Treatment depends on how advanced the disease is. Early stages may need simple management, while advanced stages require surgical correction.

1. Hypertonic Saline Drops (5%):  Used to pull out excess fluid and temporarily improve clarity.

2. Drying Techniques:  Using a hair dryer at arm’s length helps reduce morning blurriness by minimizing corneal moisture.

3. Avoiding Contact Lenses: Lenses can worsen swelling and discomfort.

4. Control of Eye Pressure:  If intraocular pressure is high, medications may be used.

Advanced Surgical Treatments

In moderate to severe Fuchs’ Dystrophy, surgery offers the best long-term results.

DMEK (Descemet Membrane Endothelial Keratoplasty)

• Most advanced and precise
• Replaces only the diseased endothelial layer
• Fast recovery and excellent vision outcome

DSEK / DSAEK

• Thicker graft compared to DMEK
• Provides great results for advanced cases

Full Corneal Transplant (rarely needed)

Used only when other options are not possible.