Fuchs’ Dystrophy Signs and Symptoms
As the cornea is one of the more important refractive elements of your eye, Fuchs’ dystrophy can lead to blurred vision, halos, or glare.
You may also experience eye discomfort in bright light and reduced contrast sensitivity. Your eyes can feel gritty and painful too.
Fuchs’ dystrophy typically affects both eyes and can cause your vision to gradually worsen over the years. Although for many patients, the condition progresses slowly and doesn’t develop any visual acuity problems.
Blurred vision in the morning is the first sign of Fuchs’ dystrophy (stage 1). At the early onset, you might also have difficulty seeing in low light.
The excess fluid builds up overnight as you sleep. So, you get a fluctuation in vision, with worse symptoms in the morning after awakening and gradually improving during the day.
This visual improvement happens because when your eyes are open, the excess fluid in the cornea evaporates from the surface. The blurriness usually gets worse when the humidity level is high, though.
As the disease progresses then comes stage 2. So, impaired vision can take longer to improve (even up to the entire day) or doesn’t improve at all.
Although a patient is born with the disease, it is not detectable or symptomatic until the 30s and 40s. Some patients don’t develop symptoms until they reach their 50s or 60s.
What is Cornea Guttata?
During the disease’s progression, the layer of cells (endothelium) responsible for maintaining proper fluid levels in the cornea will deteriorate and cause tiny bumps (guttae) to form on the back of the cornea.
Hence, cornea guttata is the initial alteration of Fuchs’ dystrophy.
These tiny drop-shaped irregular lumps in the corneal endothelium can only be seen using a special microscope.
Cornea guttata contributes to the ongoing cell death within the cornea, leading to worsening vision problems. They can cause glare and halos.
What are Fuchs’ Dystrophy Treatment Options?
There’s no cure for Fuchs’ dystrophy.
However, the early stages of the disease (cornea guttata) can be treated with non-surgical solutions such as 5% sodium chloride eye drops or salty eye ointments. They are used to draw the excess fluid from the cornea.
You could use a hairdryer, held at arm’s length, to gently blow warm air on your face (two or three times a day). This helps dry the surface of your cornea.
If you experience light sensitivity, you can find light-activated sunglasses or photochromic lenses helpful. These lenses turn darker in brighter sunlight.
Polarised lenses or anti-reflective coating may also help minimize glare reflected from flat surfaces such as water.
If Fuchs’ dystrophy isn’t affecting your vision or is only causing mild symptoms, you won’t need any treatment. But, your eyes should be routinely examined to monitor the progression of the condition.
However, the best option is cornea transplant surgery when the disorder is pretty advanced or you develop corneal scarring.
Fuchs’ Dystrophy and Cataracts
Fuchs’ dystrophy and cataracts are more common as you get older, so they can often happen together. However, they do not make each other worse.
In cases of mild Fuchs’ severity with cataracts, cataract surgery alone may be an option.
Following cataract surgery, a corneal transplant may be necessary only if Fuchs’ dystrophy worsens after surgery.
Even though cataract surgery is usually very successful, any surgery to the eye can further damage the already-delicate endothelial cells or reduce their number.
This may result in corneal decompensation, aka corneal swelling, and may need to be followed up by, or combined with, an endothelial keratoplasty transplant.
So, a careful assessment of the cornea is mandatory before cataract surgery is performed.
In cases of advanced Fuchs’ dystrophy, both cataract surgery and a corneal transplant can be done simultaneously. By using this approach, patients can benefit from a shorter recovery time.
How Much does Fuchs’ Dystrophy Surgery Cost?
Fuchs’ Dystrophy surgery cost depends on the technique performed.
If you want to receive a quote, please, fill in the contact form. You can send us your recent medical reports, so we can offer you the solution that best suits your needs.
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CORNEA GUTTATA AND FUCHS’ DYSTROPHY SPECIALISTS AT BARRAQUER EYE HOSPITAL:
External links – Bibliography
Epithelial Ingrowth After Descemet Membrane Endothelial Keratoplasty. Álvarez de Toledo C, Salvador-Culla B, López JC, De la Paz MF, Barraquer RI, Álvarez de Toledo J.
Keratoplasty in Fuchs’ dystrophy and bullous keratopathy. Barraquer J.
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