Fuch's dystrophy is a progressive disease that affects the cornea. The cornea is like the crystal covering a clock face, a clear round dome covering the iris (the colored ring in the center of the eye), and the pupil (the black circle in the middle of the iris). Fuch's dystrophy occurs after age 40 and studies show that it is an inherited condition.
Fuch's dystrophy reduces the number of cells in the cornea's inner layer (endothelial layer), which causes the remaining cells to become abnormally thick or swollen. Disordered endothelial cells also produce abnormal, dew-drop shaped outgrowths known as guttate.
These cell changes may cause the cornea to become swollen and cloudy, losing its crystal clear transparency. Because Fuch's dystrophy is a progressive disease, over time, the changes to the corneal cells may interfere with vision.
A patient with Fuch's may experience hazy or cloudy vision, with the disease usually developing over two stages.
Stage 1 may produce none or mild symptoms. In this stage, the swelling of the corneal cells usually occurs in the morning, then tends to clear as the day progresses. Vision is worse in the morning because closing your eyes during sleep keeps moisture from evaporating out of the cornea.
During Stage 2, vision no longer gets better later in the day. People with Stage 2 Fuch's may experience pain and sensitivity to light. Over time, some patients may develop scarring at the center of the cornea. Once scarring is present, the patient may become more comfortable, but the scar tissue over the cornea reduces vision.
It can take decades for Fuch's to get to the late stage. If the end stage of Fuch's results in significant loss of vision, your ophthalmologist can perform a corneal transplant. Fortunately, in most patients, Fuch's does not progress so far that a corneal transplant is needed.
The treatment for Fuch's dystrophy varies according to the severity of the disease. Treatment options will depend on your particular condition, such as whether you have a cataract and the degree of changes in your corneal cells.
To control Stage 1, the eye doctor may prescribe one or more of the following treatments:
In Stage 2, you may need to wear a therapeutic bandage contact lens to lessen discomfort.