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Fuchs’ endothelial dystrophy

In Fuchs’ endothelial dystrophy, the cornea of the eye becomes cloudy over time. This causes blurred or hazy vision that progressively worsens.

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What is Fuchs’ endothelial dystrophy?

Fuchs’ endothelial dystrophy is a disease of the cornea – the clear window at the front of the eye. The cornea allows light to enter the eye and is the main part of the eye used for focusing.

The cells lining the cornea (endothelial cells) help maintain fluid balance and prevent the cornea from swelling. In Fuchs’ endothelial dystrophy, the endothelial cells gradually die and fluid builds up within the cornea. This makes it difficult to focus, causing blurred vision.

The condition usually affects both eyes. It can worsen with age and cataract surgery.

How common is Fuchs’ endothelial dystrophy?

Fuchs’ endothelial dystrophy affects one in every 25 Australians over the age of 40. This is almost half a million people.

What are the causes and risk factors?

It is unknown what causes the endothelial cells of the cornea to die. However, there are three main risk factors for developing the disease:

  • Family history – the condition is often inherited.
  • Age – the disease typically starts when people are in adulthood. But most people don’t develop symptoms until they reach their 50s.
  • Sex – Fuchs’ endothelial dystrophy is more common in women than in men.

What are the signs and symptoms?

Fuchs’ endothelial dystrophy tends to progress slowly over many years.

In the early stage of the condition, you may notice few ­– if any – symptoms. Vision may be hazy in the morning but improve as the day goes on.

As the condition progresses, vision will typically remain blurry all day. Other symptoms may include:

  • Pain
  • Sandy or gritty feeling in your eyes
  • Being extra sensitive to bright light

If you have these symptoms, especially if they get worse over time, see your eye healthcare provider.

How is Fuchs’ endothelial dystrophy diagnosed?

An ophthalmologist or optometrist can detect the disease with an eye exam.

They will measure the thickness of your cornea and check for tiny blisters at the front and bumps at the back. They may also count your endothelial cells using a special photo of your cornea.

What treatment is available?

There is no medical treatment for Fuchs’ endothelial dystrophy. But it is possible to control the symptoms and minimise vision loss.

Eye drop medications or ointments can reduce swelling in the cornea. Self-care strategies, such as drying the surface of the cornea with a hairdryer, can also help.

If the disease is advanced and there’s vision loss, you may need a corneal transplant. This operation replaces the impaired corneal cells with all or part of a healthy clear cornea from a donor.

Your eye healthcare provider will discuss what treatments are best for your condition.

Can Fuchs’ endothelial dystrophy be prevented?

Fuch’s endothelial dystrophy cannot be prevented. But having regular eye exams after the age of 50 can catch the disease before it starts causing pain and vision loss.

What research into Fuchs’ endothelial dystrophy is happening at CERA?

Dr Elaine Chong is researching a new treatment for Fuchs’ endothelial dystrophy. Dr Chong’s study will investigate whether removing the innermost layer of the cornea can improve vision, without needing a full corneal transplant.

CERA researchers are also developing stem cell technologies that can replace the inner cells of the cornea. This technology has the potential to produce enough cells from one donor to treat many people.

Associate Professor Mark Daniell leads CERA’s Corneal Research Unit. This unit looks at new treatments for diseases of the cornea and ways to improve corneal transplant. The ultimate aim of corneal transplant research is to develop an artificial cornea and grow corneal cells in the lab. This is to prevent problems with rejection and supply of donor tissue.

How can I help?

You can support Fuchs’ endothelial dystrophy research at CERA by making a donation.