Fuch’s Dystrophy

Fuch’s dystrophy is a genetic eye condition that results when the back surface of the cornea (known as the endothelium) breaks down, allowing more fluid than normal into the cornea which causes it to swell. As the swelling progresses, the cornea becomes hazy and thus vision becomes blurred/cloudy. This may be worse in the morning when you wake up. In more severe cases the swelling can cause blister-like lesions on the front surface of the cornea, causing pain when they rupture (usually in the morning). Because the condition is slow to progress, you will probably notice symptoms gradually get worse.

Treatments include eye drops or surgery to replace the corneal endothelium. The eye drops which dehydrate the cornea can be used to slow progression/stabilize the condition. They are not necessarily successful for everyone and they do not cure the condition.

The surgery option is called a Descemets Membrane Endothelial Keratoplasty (DMEK). In a normal eye the endothelium of the cornea acts like a pump to keep just the right amount of moisture in the cornea. Because it is just the endothelium that is causing the swelling in Fuch’s, it is only that part of the cornea that is replaced during the surgery. This technique has only come about in recent years and has the advantage of a faster visual recovery, more predictable glasses prescription post-surgery, and less risk of rejection compared to the traditional full thickness corneal graft.