Fuchs Endothelial Dystrophy
Fuchs is an inherited dysfunction of the endothelial cells on the inside of your cornea, facing the inside of the eye. Normally, these cells function as a “pump” to dehydrate the cornea of excess fluid, thereby keeping your cornea optically transparent and clear. As a part of the natural aging process of the cornea, the number of these endothelial cells steadily decline but usually not significant enough to cause visual problems. However, a condition like Fuchs endothelial dystrophy may cause these cells to decline earlier and faster, thereby resulting in corneal edema (accumulation of excess fluid in the cornea) and visual decline. Early symptoms may include blurry vision that is worse in the morning and improves by the evening. In the office, the doctor may monitor the progression of corneal edema by routinely checking your corneal thickness using an ultrasound. You may also directly view your corneal cells for irregularities, similar to the photos below.
Normal corneal cells
Fuchs endothelial dystrophy with guttata (black gaps represent loss of cells) present
What are treatment options?
Mild Fuchs usually is asymptomatic and does not require any treatment. However, once a significant number of cells are lost and fluid begins to accumulate in the cornea, treatment options may be discussed with your doctor.
Conservative treatments are limited to hypertonic saline (drops and/or ointment). By applying this medication, it helps draw fluid out of the cornea from the surface. This may help mitigate some mild corneal edema, but is not a cure.
A more definitive treatment for Fuchs is surgical. If Fuchs is significant and visually debilitating, then your doctor may discuss a partial-thickness corneal transplant (I.e. DMEK, DSAEK).