Fuch’s (pronounced fewks) Dystrophy or just Fuch is a disease of the cornea, the clear outer coating of the eye. It is when cells in the very bottom layer of the cornea called the endothelium gradually die off. These cells are responsible for pumping fluid from the cornea to keep it clear so that images are clear. When they die, the fluid builds up in the cornea and causes swelling which makes vision cloudy or hazy.
There are two stages in the disease. During the early stage, vision typically is hazy in the morning and clears up by the afternoon. In stage 2, vision stays blurred all day long.
Fuch’s Dystrophy generally effects both eyes. Women are more likely to have Fuch’s than men. People can start to show signs of it in their 30s and 40s but may not be symptomatic until age 50 or later. Family history of Fuch will also increase your risk of developing the disease.
Stages
In stage 1, symptoms are few. Vision may be hazy when you get up in the morning and it will improve throughout the day. This happens because typically our eyes stay moist while we are sleeping since they are closed, but when you are awake, the fluid dries normally.
In stage 2, the blurry vision sticks around all day long. Too much fluid builds up while you are asleep and not enough dries up during the day. Tiny blisters may also form on the surface of the cornea. They can break open and cause a lot of pain. Other symptoms include gritty feeling eyes, light sensitivity, eye problems worsening in humid climates, and blurry vision from scarring.
Diagnosis
Your eye doctor will be able to see drop-like bumps on the back surface on the cornea called guttata. To me, the guttata look like a puppy dog nose. There is also a special piece of equipment that can actually count the number of endothelial cells that you have. Pachymetry can also be performed, which is a measurement of the thickness of the cornea.
Other Corneal Diseases
There are lots of other corneal diseases that can give similar patient symptoms. Some of those disease are keratoconus, pellucid marginal degeneration, and endothelial basement membrane dystrophy.
Treatment
Unfortunately, there is no cure for Fuch Dystrophy. Treatment is aimed at controlling the vision problems due to corneal swelling.
Treatment for early Fuch’s includes an eye drop or ointment called muro-128 that will reduce the swelling of the cornea. You can also use a hair dryer to blow warm air onto your face to help dry the surface of the cornea.
For later stages where vision is extremely poor and the cornea is scarred, corneal transplantation may be needed. There are two types of surgeries. One is called and endothelial keratoplasty (EK) where healthy endothelial cells are transplanted into the cornea. The other is a full corneal transplant where the center of your cornea is replaced with a healthy donor cornea.
For some interesting pictures of different eye diseases, check out our image library of eye diseases. We add diseases to this database regularly like macular degeneration and central serous chorioretinopathy.
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