What It's Like Living With Fuch's Dystrophy

Most of us are familiar with the most common eye problems — glaucoma, cataracts, dry eye syndrome, and macular degeneration. Information concerning these conditions seems to be easy to obtain. However, Fuch’s Dystrophy is a less common eye affliction and those affected by it usually leave the healthcare provider’s office with several unanswered questions. Educating yourself about the condition can be a challenge. If you or someone you know has been diagnosed with Fuch's Dystrophy, the following will help you become more informed.

Understanding treatment decisions.
Ariel Skelley / Getty Images

Overview

Fuch’s Dystrophy is an inherited eye condition that causes a disorder in the cornea, the clear dome-like structure on the front part of our eye. The cornea is composed of six layers of cells with endothelial cells being the last layer on the backside of the cornea. One of the functions of the endothelial cells is to continually pump the fluid out of the cornea, keeping it compact and clear. When these cells start to fail, fluid builds up in the cornea causing stress on the cells. The cornea swells and vision becomes cloudy. In severe forms of Fuch’s Dystrophy, the cornea can decompensate.

The severity of Fuch’s Dystrophy can vary. Many patients do not even know they have the condition while others can become frustrated with decreased vision. However, most patients maintain a good level of vision to function very well with daily activities.

Does Fuch's Dystrophy Cause Blindness?

With today’s technology, blindness is almost non-existent for patients suffering from severe Fuch’s Dystrophy. It is important to understand that Fuch’s Dystrophy does not affect the retina, the light-sensitive receptor layer of the cornea or the optic nerve, the nerve cable that connects the eye to the brain. The cornea gives the eye most of its refractive power. In severe forms of the disease, a corneal transplant or a new procedure called DSEK can restore near-normal function to the cornea.

Possible Symptoms

Some patients complain of blurred vision in the morning that seems to get a little better as the day continues. This is because fluid builds up in the cornea overnight. As you wake up and go about your day, the eye is open to the environment and the fluid actually evaporates out of the cornea and vision tends to get better. You can also experience seeing rainbows or halos around lights, glare, and your vision could appear foggy. Some patients complain of eye pain or a foreign body sensation in their eyes.

Treatment

Treatment of Fuch’s Dystrophy in the early stages is quite simple. Usually, it involves instilling a 5% sodium chloride solution or ointment into the eyes to draw out the fluid. The 5% sodium chloride is a salt-based compound that is usually instilled two to four times per day. Some patients get better results by using the ointment formulation that they only put into their eyes at night.

Disease Progression

Some patients never develop a severe form of Fuch’s Dystrophy. However, if it advances to a more severe stage, you may develop bullous keratopathy. This is where fluid-filled bullae or blisters form and make vision blurry and can erupt and cause significant eye pain and foreign body sensation. In this case, some healthcare providers will place a bandage contact lens on your eye and prescribe medicated eye drops. If the condition worsens, your practitioner may recommend a corneal transplant or a DSAEK procedure. DSAEK (Descemet’s Stripping Automated Endothelial Keratoplasty) is a procedure in which only the back part of the cornea is replaced with healthy endothelial cells. A DSAEK procedure has fewer complications than a total corneal transplant and the resulting vision is much better.

Genetic Component

Some cases of Fuch’s Dystrophy seem to have no genetic pattern. However, most cases have what is known as an autosomal dominant inheritance pattern. This means that if you have the condition and one of your parents had the condition, each child has a 50% chance of having Fuch’s Dystrophy.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Royal National Institute of Blind People. Fuchs dystrophy.

  2. Ayres BD. Fuch's endothelial dystrophy. American Academy of Opthamology.

  3. Cornea Research Foundation of America. Fuch's dystrophy.

  4. American Academy of Opthamology. Fuchs' endothelial dystrophy - Europe.

By Troy Bedinghaus, OD
Troy L. Bedinghaus, OD, board-certified optometric physician, owns Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association.