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Fuchs' Corneal Dystrophy
Fuchs' dystrophy is an
inherited condition that affects the delicate inner layer (endothelium)
of the cornea. The endothelium functions as a pump mechanism, constantly
removing fluids from the cornea to maintain its clarity. Patients
gradually lose these endothelial cells as the dystrophy progresses. Once
lost, the endothelial cells do not grow back, but instead spread out to
the fill empty spaces. The pump system becomes less efficient, causing
corneal clouding, swelling and eventually, reduced vision.
In the early
stages, Fuchs' patients notice glare and light sensitivity. As the
dystrophy progresses, the vision may seem blurred in the morning and
sharper later in the day. This happens because the internal layers of
the cornea tend to retain more moisture during sleep that evaporates
when the eyes are open. As the dystrophy worsens, the vision becomes
continuously blurred.
Fuchs' affects both eyes and is slightly
more common among women then men. It generally begins at 30-40 years of
age and gradually progresses. If the vision becomes significantly
impaired, a corneal transplant may be indicated. Sometimes corneal
transplant (also known as penetrating keratoplasty or PKP) is performed
along with cataract and intraocular lens implant surgery.
SIGNS
AND SYMPTOMS
•Hazy vision that is often most pronounced in the
morning
•Fluctuating vision
•Glare when looking at lights
•Light sensitivity
•Sandy, gritty sensation
DETECTION AND
DIAGNOSIS
Fuchs' is detected by examining the cornea with a slit lamp
microscope that magnifies the endothelial cells thousands of times. The
health of the endothelium is evaluated and monitored with pachymetry and
specular microscopy
TREATMENT
Fuchs' cannot be cured;
however, with certain medications, blurred vision resulting from the
corneal swelling can be controlled. Salt solutions such as sodium
chloride drops or ointment are often prescribed to draw fluid from the
cornea and reduce swelling. Another simple technique that reduces
moisture in the cornea is to hold a hair dryer at arm’s length, blowing
air into the face with the eyes closed. This technique draws moisture
from the cornea, temporarily decreases swelling, and improves the
vision.
Corneal transplant is indicated when the vision
deteriorates to the point that it impairs the patient’s ability to
function normally.
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