You thought your blurry vision just meant you needed a stronger eyeglass prescription. However, your ophthalmologist diagnosed you with Fuchs’ Corneal Dystrophy – a fairly rare condition that leads to progressive blurred vision due to clouding of the cornea. Naturally, you have many questions about the disease and treatment options.
Washington University ophthalmologist and surgeon, Augustine Hong, MD, specializes in corneal disease and refractive surgery. He explains, “The cornea is the clear covering at the very front of the eye. Fuchs’ Corneal Dystrophy causes this clear covering to appear foggy, usually in both eyes. Symptoms include blurry vision, glare, and haloes, especially in the early morning, and also with bright lights. Later on, patients may experience eye irritation or a foreign body sensation.
Blurry vision is caused by a disorder of the clear sheet of cells called Descemets membrane that normally coats the back surface of the cornea. Healthy cells prevent swelling and keep the cornea clear.
In Fuchs’ Dystrophy, the cells deteriorate more quickly with age, trauma or surgery, causing the cornea to become swollen, blurry, and sometimes uncomfortable. The sheet of cells also develops many small growths called guttata that appear as frosted glass. The guttata may also contribute to blurry vision, glare and haloes.”
Although approximately 4% of the US population may be affected by Fuchs’ Dystrophy, many of these people do not have symptoms and are not bothered. The condition usually begins to affect people in their 50s and up. It can be inherited, so children of parents with Fuchs’ Dystrophy may be at risk.
Diagnosing the disease
Fuchs’ Dystrophy is diagnosed with careful microscopic examination by an eye doctor. The doctor may perform additional testing to help decide which treatment option is best. These additional tests may include measuring the thickness of the cornea or taking a special photo to count the number of healthy remaining cells on the endothelium.
Treatment
Fuchs’ Dystrophy can be treated surgically with corneal transplantation, a procedure that replaces the dysfunctional sheet of cells with a new human donor corneal graft.
Early symptoms of Fuchs’ Dystrophy can be treated with sodium chloride eye drops, which help to draw fluid out of from the cornea and temporarily reduce corneal swelling. This does not cure the disease.
New advancements
A procedure called Descemet’s Membrane Endothelial Keratoplasty, or DMEK, is a newer form of corneal transplantation that replaces the diseased sheet of cells with a new sheet of cells. Compared with traditional techniques, DMEK speeds the recovery of the vision, and reduces the amount of astigmatism and size of the corneal incision.
Some studies have shown that DMEK can lead to lower rates of corneal graft rejection, leading to a longer, healthier life of a corneal graft. In complex or advanced cases, a traditional technique is preferred over the newer technique.
According to Dr. Hong, “Patients with Fuchs’ Dystrophy should know that cataract surgery or other eye surgery can cause worsening of the Fuchs’ Dystrophy and hasten the need for corneal transplantation. Therefore, patients with moderate or advanced Fuchs’ Dystrophy may often receive a corneal transplantation at the same time as cataract surgery. LASIK is not recommended.”
To make an appointment with Dr. Hong, please call 314-273-0020.
Center for Advanced Medicine – South
5201 Midamerica Plaza Suite 2500
St. Louis, MO 63129
VA Medical Center: John Cochran Division
915 North Grand Blvd.
St. Louis, MO 63106