Fuch’s Dystrophy

Fuch’s dystrophy, sometimes called endothelial dystrophy, is an eye disease that causes the cells in the innermost layer of the cornea (endothelium) to die off. These cells are responsible for pumping fluid and impurities out of the cornea. As these cells die off fluid is no longer removed and the cornea begins to swell distorting its shape and causing it to become hazy. Blisters can form on the cornea as water tries to escape. When the blisters burst it is extremely painful and can leave scars on the cornea.

Cause
Fuch’s dystrophy is inherited. Some people are never aware of having it, and therefore not aware of the risk of passing it on to their children.

Symptoms
Fuch’s dystrophy is often detected when a person is in their 30’s or 40’s, with vision loss becoming noticeable in their 50’s or 60’s, but Fuch’s does not always progress to a debilitating stage. The corneal swelling, haze, and the scars caused by blisters can impair vision. For some the disease leads to blindness.

Hazy vision
Fluctuating vision - worse upon waking, improving as the day goes on
Glare
Light sensitivity
Watery eyes
Burning eyes
Decreased depth perception
Foreign object sensations (feels like sand or grit in the eyes)
Sharp pains in the eyes
Symptoms, especially blurry vision, are usually worse when first waking up since moisture does not evaporate on its own while the eyes are closed and swelling increases throughout the night.

Treatment
There is no true cure for the disease. However, there are some treatments which can control the swelling, visual impairment, and pain.

Muro. A salt solution containing sodium chloride can be used in eye drop or ointment form to draw fluid from the eye.
Steroids. Steroid eye drops can provide relief for some patients.
Soft contact bandage. A soft contact lens can be worn as a bandage for short periods of time to help with pain and swelling, but extended periods of use can cause infection.
Hair dryer. As crazy as it may sound, doctors often recommend using a hair dryer to dry out the eyes. The hair dryer is held at arms length and air is directed across the face to help evaporate moisture from the eyes. It is recommended to do this several times a day.
Corneal transplant. Eventually, a corneal transplant may be necessary. In the short term, corneal transplant is very successful, but the new cornea may not survive long term. For this reason, some doctors may suggest waiting as long as possible for a corneal transplant. Those who have experienced the disease recommend having the transplant as soon as the symptoms affect your daily life, because you will need to rely on the non-transplant eye for vision while the eye which has received the transplant heals.
Unfortunately, LASIK surgery is not appropriate if you have Fuch’s dystrophy. For some LASEK, PRK, or Epi-LASIK may be a safe alternative, but only if the disease is not too advanced.

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If you have Fuch’s dystrophy and are considering LASIK, talk to your ophthalmologist about safe alternatives today.