Informational Brochure Fuchs’ dystrophy Fuchs’ dystrophy is a slow progressing eye condition Fuchs’ Dystrophy where the cornea (the clear front window of the eye) eventually loses the ability to pump-out excess fluid causing Dr. Martin McCarthy, MD, FRCSC blurry or hazy vision and glare. Clinical Associate Professor Department of Ophthalmology and Visual Sciences University of British Columbia Contact The Eye Care Centre—Sec G 2550 Willow Street A hazy cornea with Fuchs’ dystrophy Vancouver, BC, Canada, V5Z 3N9 Phone: +1(604) 875-4407 Fuchs’ dystrophy was named after Austrian ophthalmologist or Ernst Fuchs who first described The Surrey Eye Care Centre it in 1902. 13490 - 104th Ave Eye Facts Surrey, BC, Canada, V3T 1V8 Phone: +1(604) 930-1010 This brochure does not constitute professional medical advice. You should discuss your condition with a licensed ophthalmologist. What is Fuchs’ dystrophy? Fuchs’ dystrophy is a slow progressing disease that usually affects both eyes. It is slightly more common in women than in men. Although doctors often see early signs of Fuchs’ dystrophy in people in their 30s to 40s, the disease rarely affects vision until people reach their 50s and 60s. Fuchs’ dystrophy occurs when the cells in the back layer of your cornea called the endothelium gradually stop functioning and deteriorate over time. What are the symptoms of Fuchs’ dystrophy? Depending on the degree of endothelial degeneration, Fuchs’ dystrophy can have mild to severe effects on your vision and may affect one eye more than the other. Early signs of Fuchs’ dystrophy: • Blurry or hazy vision in the morning that gradually improves as the day goes on • Glare and halos when looking at lights • Sensitivity to light • Fluctuating vision • Sandy or gritty sensation when blinking Surgical treatment The primary surgical treatment for advanced Fuchs’ dystrophy is a type of corneal transplant called Descemet’s stripping automated endothelial keratoplaty, or DSAEK for short. In DSAEK surgery the damaged endothelial layer is replaced with a donor while the healthy remaining layers are left untouched. New endothelial layer Corneal guttata Signs of advanced Fuchs’ dystrophy : • Blurriness or haziness that does not go away • Severe visual impairment • Pain from epithelial blisters Shown above is a highly magnified image of an eye with corneal “guttata,” one of the characteristic signs of Fuchs’ dystrophy What causes Fuchs’ dystrophy? Fuchs’ dystrophy has a strong genetic component. It is thought to have an autosomal-dominant pattern of inheritance, meaning that if one parent has Fuchs’ dystrophy the child has a 50% chance of having the disease. Little is known about environmental factors that might contribute to it’s development or why it is more common in women. How is Fuchs’ dystrophy treated? Fuchs’ dystrophy does not always progress to the point that surgical treatment is required. Early on, your doctor may prescribe hypertonic saline to dehydrate your cornea and clear your vision. A hairdryer held at arms length may also be used to dry out excess moisture. Unfortunately, in a small percentage of cases, Fuchs’ dystrophy progresses to the point that acceptable vision can no longer be maintained or the pain becomes intolerable. In those cases surgical intervention is the next step. DSAEK endothelial replacement DSAEK is favoured over traditional fullthickness corneal transplants because it has less graft rejection, a quicker visual recovery and a reduced need for postoperative topical steroids. However, if there is significant corneal scarring, a traditional full-thickness corneal transplant is usually necessary. Fullthickness corneal transplants for Fuchs’ dystrophy have a high success rate, with over 85% remaining clear after 2 years. Please arrange an appointment with Dr. McCarthy if you would like more information on your condition and the treatment options available