Fuch's Corneal Dystrophy
Fuchs’ corneal dystrophy is a progressive disorder affecting the cornea, transparent layer situated in the front part of the eye and covering the anterior chamber, the iris and pupil. Quite uncommon and defined by a slow development of symptoms, this disorder manifests through the buildup of excess fluid within the cornea.
Affecting approximately 1% of people, this eye disease is more common in women and people aged 50 or older. Also, those with family history for eye diseases - especially endothelial dystrophy – are more prone to developing this ailment.
How does Fuchs’ corneal dystrophy appear?
This disorder appears when cells forming the endothelium or inner layer of the cornea get damaged or lose their function and die, as this layer is responsible for draining water out of the eyes. With no viable cells to remove excess fluid, the cornea gets swollen and loses its transparency, leading to cloudy vision and all the other specific manifestations of this ailment.
But what exactly alters the corneal layers? In a normal eye, water is secreted for maintaining the membranes properly moisturized, for allowing light to pass and ensuring normal vision. But in some people, a smaller or larger number of cells inside the cornea have genetic defects thus they can’t function properly. As a result, water builds up inside the endothelium and small excrescences called guttate lesions form between the corneal layers.
These bumps enlarge and alter the regular form of endothelial cells surrounding them, causing their death eventually. The remaining cells have to cover the resulting gaps, but most of the times they’re unable of draining all the fluid so the cornea gets swollen and cloudy and Fuchs’ corneal dystrophy occurs.
Besides these mechanisms, free radicals affecting the cells in the back of the eyes, heredity and nutritional deficiencies – especially the lack of fatty acids, antioxidants, zinc, vitamin B and selenium – can also trigger this eye disease.
What are the symptoms of this ailment?
As already said, Fuchs’ corneal dystrophy manifests through blurred vision appearing mostly on awakening and gradually clearing up throughout the day, tiny bumps or blisters formed on the cornea and generalized eye pain and discomfort. The cornea has a cloudy appearance, quite visible with the naked eye. Other symptoms experienced by people affected by this disorder are an increased sensitivity to light, distorted vision and difficulties seeing at night. In severe cases blindness can also occur.
Treatment options for Fuchs’ dystrophy
While the only real cure that permanently puts an end to vision problems caused by this ailment is surgery, there are some remedies that can help in temporary relieving the symptoms:
- Eye drops and specific eye ointments can stimulate fluid drainage, reducing corneal swelling. Most dehydrating ointments and eye drops contain sodium chloride and have to be used 4-6 times a day for proper results.
- Wearing soft contact lenses can reduce discomfort and improve vision.
- Applying warm compresses on the eyes can help reduce blisters and dry excess fluid. Also, drying the eyes with a hair dryer kept at arm’s distance may help in improving vision for some hours.
In what concerns the surgical treatment performed in patients with Fuchs’ corneal dystrophy, its purpose is to replace the damaged cornea with a new one, taken from a donor. The corneal transplant is called keratoplasty and manages to restore normal vision, keeping symptoms away for many years.
Depending on the severity of the ailment, the procedure can be performed for the entire cornea or only for the affected layers, in both cases the results being encouraging. Still, endothelial keratoplasty – the procedure during which only some of the corneal layers are replaced – is considered more convenient for the patient as it triggers minimal changes in glass prescription and the recovery process is faster.
Although very effective, this surgical procedure has its drawbacks:
- An increased risk of rejection, leading to eye sensitivity, pain and redness
- A limited number of available donors at a specific moment
- A sensation of discomfort right after the procedure
- The need of using eye drops for several weeks or months, until the eyes heal completely