Fuchs’ Endothelial Corneal Dystrophy
What is Fuchs’ Endothelial Corneal Dystrophy?
Fuchs’ Endothelial Corneal Dystrophy (FECD) can be thought of as an abnormal, premature aging of the endothelium of the cornea. The endothelium is the layer of cells that lines the inside of the cornea (the transparent window at the front of the eye) and are responsible for keeping it clear. Loss of the endothelial cells results in the cornea becoming swollen, cloudy and, later, painful.
Risk Factors
Older populations (over 50 years of age), more commonly women, and those with a family history of Fuchs’ Endothelial Corneal Dystrophy are at increased risk of developing this disease.
Symptoms
Fuchs’ Endothelial Corneal Dystrophy causes blurring of vision, at first more noticeable in low-contrast situations (e.g. differentiating grey objects on a grey background).
Diagnosis
Fuchs’ Endothelial Corneal Dystrophy can be diagnosed and monitored by an ophthalmologist, with the aid of corneal topography.
Natural History
Fuchs’ Endothelial Corneal Dystrophy is slowly progressive, and the vision will not improve by itself. Over several years, the vision becomes increasingly blurred, first in one eye, then the other eye. Early in the disease, blurring tends to be worse in the mornings, but this eventually occurs all day long. Fuchs’ Endothelial Corneal Dystrophy will eventually cause vision loss in both eyes, and painful blisters may also develop in the later stages.
Treatment
Ultimately, patients with Fuchs’ Endothelial Corneal Dystrophy whose vision loss is impacting on their quality of life will require corneal transplant (graft) surgery.
Some patients with limited Fuchs’ Endothelial Corneal Dystrophy (FECD) may be suitable for Descemet’s Stripping Only (DSO), also called Descemetorhexis Without Endothelial Keratoplasty (DWEK) surgery. This involves removing the affected central endothelium, and allowing the healthier cells on the periphery of the corneal endothelium to migrate inwards without the need for corneal transplantation.
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