Fuchs’ endothelial dystrophy is a non-inflammatory, sporadic or autosomal dominant, dystrophy involving the endothelial layer of the cornea. With Fuchs’ dystrophy the cornea begins to swell causing glare, halos, and reduced visual acuity. The damage to the cornea in Fuchs’ endothelial dystrophy can be so severe as to cause corneal blindness.
Some of the earliest symptoms of Fuchs’ endothelial dystrophy include reduced contrast sensitivity and mild reduction of visual acuity. Patients will often notice glare around a point source of light or have difficulty with nighttime driving. As the dystrophy is often slow in onset, patients may not even notice that their vision is reduced. Once fluid begins to collect in the stroma, patients will start to notice fluctuation in vision, typically worse in the early AM and improving toward the end of the day.
Medical treatment of Fuchs’ dystrophy begins once patients notice fluctuations in vision. The early treatment is usually in the form of hypertonic saline (such as Muro 128 or sodium chloride) eye drops and/or ointments. Use of the hypertonic saline may stabilize or improve vision by drawing extra water out of the cornea.
As Fuchs’ dystrophy progresses, medical treatment may fail and surgical management becomes necessary.