With this disease, cells in the cornea’s inner layer, called the endothelium, are reduced in number. This causes the remaining cells to swell or thicken. The loss of endothelial cells can also allow abnormal dewdrop-shaped growths called guttata to form.
These cell changes may cause the cornea to become cloudy and swollen. Because Fuchs’ dystrophy is a progressive disease, the changes to the cornea can interfere with vision over time. Fuchs’ dystrophy usually occurs in people after age 40. Studies show that it is an inherited condition.
Symptoms of Fuchs’ dystrophy include hazy or cloudy vision that develops in stages. In the first stage, as the cornea swells, vision in the morning may be hazy, but it clears up during the day. Once the disease has progressed to a more advanced stage, vision no longer clears, and instead, you may experience pain and sensitivity to light.
It can take up to 20 years or longer for Fuchs’ dystrophy to progress from its earliest stage to a stage that is visually or physically significant. To diagnose and monitor this condition, an ophthalmologist, Dr. Kent Small, checks for adequate endothelial cell number and function, obtains an endothelial cell count, and may measure the thickness of the cornea.
In its early stage, Fuchs’ dystrophy is treated with saline eyedrops to pull excess fluid from the cornea or by using a hairdryer to help dry the surface of the cornea. As Fuchs’ dystrophy advances, you may be given a therapeutic bandage contact lens to lessen your discomfort.
If vision loss begins to interfere with your life in the latter stages of the disease, a corneal transplant technique known as penetrating keratoplasty may be performed. This procedure has an excellent success rate.