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Fuchs’ Dystrophy

Fuchs’ corneal endothelial dystrophy (FCED) is the breakdown of the cornea, the clear outer layer of the eye that allows light to enter. It is a disease that usually presents itself during middle age, and leads to vision loss. Some cases can develop earlier in adulthood. Those with a predisposition for the disease can cause symptoms to arise after receiving ocular surgery. There is a genetic predisposition for FCED, with a 50% chance of it being passed down if one parent has it. When FCED occurs, it usually occurs in both eyes. 

FCED begins when abnormal growths called guttae begin to grow in the cornea. This causes a lower layer of the membrane to thicken, which makes it harder to deliver necessary nutrients to them. Eventually, this layer of the cornea begins to deteriorate, opening up the cornea to a flow of liquid from the aqueous humor. The liquid will begin to trap itself in broken cell membranes causing blisters called bullae. These blisters, depending on severity, can be very painful. This leads to corneal scarring and severe vision loss.

The swelling of the cornea is greatest upon waking. Fluid builds up while the eyes are closed during sleep, and evaporates throughout the day. Because of this, symptoms are particularly bad during the morning and will improve throughout the day. In more severe cases, symptoms are consistently bad. The blisters, along with pain, cause poor vision and a sensitivity to light and glare. One may also experience night blindness or halos around light sources. Because of the increased fluid, high intraocular pressure and glaucoma can also arise.

FCDE can be detected during a regular visit to your doctor. Eye drops can be prescribed to help reduce intraocular pressure. Other eye drops can be prescribed to help reduce the amount of excess liquid in the cornea. If the disease is advanced enough, surgery may be necessary. There are procedures that can remove the lower levels of the cornea where the blisters are without disturbing the unaffected areas. New laser surgeries are coming out that do the same, but are much safer and more effective. If vision loss is severe enough, a total corneal transplant may be necessary.