Normal eye

Fuch's dystrophy is a disorder of the front surface of the eye. This surface is called the "cornea" and is comprised of three layers, the outer layer called the epithelium, the middle layer called the stroma and an inner layer called the endothelium. The inner delicate layer acts as a barrier to prevent water inside the eye from moving into and swelling the other layers of the cornea. The cells of the endothelium actively pump water from the cornea back into the eye. If the endothelium does not function normally, then water moves into the cornea. This leads to swelling of the cornea, resulting in a cloudy cornea and blurry vision.

Fuch's dystrophy affects both eyes and is slightly more common in women than men. On average, half of the family members of an affected person may carry or suffer from the condition. Patients often exhibit early signs of Fuch's dystrophy in their 30s and 40s, but the condition rarely affects vision until people reach their 50s and 60s. The exact cause of Fuch's dystrophy is unknown. Hereditary, hormonal and inflammatory factors probably all play a role.

In the early stages of Fuch's dystrophy, patients may not have any symptoms. As the disease progress, patients may wake up with blurry vision, which gradually clears over the day. This occurs because water continuously evaporates from the surface of the eye and is replaced with water drawn from the inside the eye. Overnight, when we sleep with closed eyes, water cannot evaporate from the surface of the eye and accumulates in the cornea, causing slight swelling which blurs vision. Once eyes are opened throughout the day, evaporation reduces the water content and the thickness of the cornea, allowing for clearing of the vision. In later stages, evaporation is not enough to remove accumulated water in the cornea, and swelling and blurred vision last all day. Patients may complain of hazy vision that is worst in the morning, fluctuating vision, glare, light sensitivity, episodes of sharp pain, sandy and gritty sensation.

Fuch's dystrophy is detected by examining the cornea with a microscope and the health of the cornea can be further evaluated with a pachymeter and specular microscopy. Fuch's dystrophy cannot be cured. The blurred vision in the early stages of the disease can be treated with medication to reduce the normal cornea swelling and inflammation. Another simple technique that reduces moisture in the cornea is to hold a hair dryer at arm's length, blowing air towards the face with the eyes open. This warm air flow increases evaporation of water from the cornea, temporarily decreases swelling, and may improve vision. This technique may not be effective in more advance stages of the disease. If the disease causes significant vision lost or discomfort, then a cornea transplant is recommended to improve vision and relief any adverse symptoms.