How Does Fuch’s Corneal Dystrophy Affect the Eye?

Corneal topography

How Does Fuch’s Corneal Dystrophy Affect the Eye?

Fuch’s corneal dystrophy is a relatively uncommon eye disease that affects the cornea. Austrian ophthalmologist Ernst Fuchs first noticed the condition and subsequently reported 13 cases of central corneal clouding, loss of corneal sensation and the formation of blisters.

The cornea is formed from five different layers of strong, tough tissue. Each layer has a specific function, and along with protecting the eye, the cornea bends light onto the retina, which is how images appear in focus. When the cornea is misshapen, it can cause nearsightedness, farsightedness, or astigmatism. The shape of the cornea can be damaged by disease, injury, or genetic conditions, and if foreign objects, disease, infection, or injury damages the cornea, the scars or damage will also affect vision.

What are the Signs and Symptoms of Fuch’s Dystrophy

Fuch’s dystrophy is an inherited condition, but although a person is born with Fuch’s, it does not generally cause a problem until middle age or later. Fuch’s is a progressive disease, which is caused by deteriorating corneal cells that can lead to corneal edema.

The layers of these cells are responsible for maintaining proper fluid levels in the cornea. When the layers begin to deteriorate, the imbalanced flow of fluid between the layers causes tiny bumps or blisters to form on the back of the cornea. As more of these cells are lost, fluid builds up in the cornea, which causes swelling, and the swelling, called corneal edema, causes vision to be clouded or blurred.

The symptoms patients will experience include:

  • A rough or gritty sensation in the eye
  • Visual discomfort from bright light
  • Fluctuating visual acuity
  • Halos and/or glares from bright lights
  • Blurry vision combined with poor contrast in colors
  • Eye pain

While not uncommon, it’s always best to check in with your Kelowna optometrist if you notice any of the above mentioned symptoms.

How is Fuch’s Dystrophy Diagnosed?

Fuch’s is first discovered during a routine eye exam, however, if your eye doctor suspects that Fuch’s dystrophy is present, he or she will conduct three tests to confirm diagnosis.

A slit lamp microscopy will be performed. This entails using a microscope with beam of light that can be adjusted from a thin slit to a round circle, depending on what part of the eye the doctor wants to see. This allows the microscope to focus and magnify and illuminate the area of eye the doctor wants to examine.

A pachymeter will be used to measure the corneal thickness. Fuch’s dystrophy causes the cornea to thicken, which makes this a crucial step in diagnosis. A confocal/specular microscope will be used to identify the number, density, and shape of the endothelial cells, which is vitally important in monitoring the progression of Fuch’s.

What is the Treatment for Fuch’s Dystrophy?

Fuch’s dystrophy usually progresses slowly, and as such, the best course of treatment in the early stages is simply prescription eye drops or ointments to reduce pain and swelling. Soft contact lenses may be recommended to help visual acuity, if needed.
It is not until the condition has progressed to the stage where there is significant corneal scarring that a corneal transplant may be suggested. If the damage has reached the stage where a transplant is necessary, there are two options: a full corneal transplant or an endothelial keratoplasty (EK).

A full corneal transplant means that the cornea will be replaced with a cornea from a donor, whereas an EK involves replacing the damaged endothelial cells in the cornea with healthy cells, however, this also requires a donor.

Does Fuch’s Dystrophy Cause Cataracts?

This is often widely confused because both conditions cause clouding of the eye lens, but Fuch’s doesn’t cause cataracts, cataracts are a natural part of aging. Unfortunately, if Fuch’s dystrophy is present, there is a higher risk of developing cataracts. If cataracts develop in addition to Fuch’s, two types of surgery are required: cataract removal and corneal transplant. Cataract surgery must be performed first, because the surgery can cause further damage to the endothelial cells.

Only 4 percent of people in the United States are affected by Fuch’s dystrophy, it is rarely detected before the age of 40, and it affects women more often than men, however, as with all eye conditions, it is vitally important to detect any problems with your vision as early as possible. Not only will this help slow progression, but it can also ensure you receive the treatment you need to help improve your day-to-day eye sight and comfort.

Regular check ups at your Kelowna optometrist will ensure any issues are caught as early as possible. For more information, contact us at Orchard Park Optometry.

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