Overview

In Fuchs' (fewks) dystrophy, fluid builds up in the clear layer (cornea) on the front of your eye, causing your cornea to swell and thicken. This can lead to glare, blurred or cloudy vision, and eye discomfort.

Fuchs' dystrophy usually affects both eyes and can cause your vision to gradually worsen over years. Typically, the disease starts in the 30s and 40s, but many people with Fuchs' dystrophy don't develop symptoms until they reach their 50s or 60s.

Some medications and self-care steps may help relieve your Fuchs' dystrophy signs and symptoms. But when the disorder is advanced and your vision is affecting your ability to function well, the best way to restore vision is with cornea transplant surgery.

Symptoms

As the disease progresses, Fuchs' dystrophy symptoms, which usually affect both eyes, might include:

  • Blurred or cloudy vision, sometimes described as a general lack of clarity of vision.
  • Fluctuation in vision, with worse symptoms in the morning after awakening and gradually improving during the day. As the disease progresses, blurred vision either can take longer to improve or doesn't improve.
  • Glare, which can decrease your vision in dim and bright light.
  • Seeing halos around lights.
  • Pain or grittiness from tiny blisters on the surface of your cornea.

When to see a doctor

If you have some of these symptoms, and especially if they worsen over time, see an eye care provider, who might then refer you to a corneal specialist. If symptoms develop suddenly, call for an urgent appointment. Other eye conditions that cause the same symptoms as Fuchs' dystrophy also require prompt treatment.

Causes

Normally, the cells lining the inside of the cornea (endothelial cells) help maintain a healthy balance of fluid within the cornea and prevent the cornea from swelling. But with Fuchs' dystrophy, the endothelial cells gradually die or do not work well, resulting in fluid buildup (edema) within the cornea. This causes corneal thickening and blurred vision.

Fuchs' dystrophy is usually inherited. The genetic basis of the disease is complex — family members can be affected to varying degrees or not at all.

Risk factors

Factors that increase your risk of developing Fuchs' dystrophy include:

  • Sex. Fuchs' dystrophy is more common in women than in men.
  • Genetics. Having a family history of Fuchs' dystrophy increases your risk.
  • Age. Although there's a rare early-onset type of Fuchs' dystrophy that begins in childhood, typically the disease starts in the 30s and 40s, with symptoms developing thereafter.

Fuchs' dystrophy care at Mayo Clinic

June 19, 2020
  1. Salmon JF. Cornea. In: Kanski's Clinical Ophthalmology: A Systematic Approach. 9th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed May 1, 2020.
  2. Yanoff M, et al., eds. Diseases of the corneal endothelium. In: Ophthalmology. 5th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed May 1, 2020.
  3. What is Fuchs' dystrophy? American Academy of Ophthalmology. https://www.aao.org/eye-health/diseases/what-is-fuchs-dystrophy. Accessed May 1, 2020.
  4. Corneal dystrophies. National Eye Institute. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/corneal-conditions/corneal-dystrophies. Accessed May 1, 2020.
  5. Brown AY. Allscripts EPSi. Mayo Clinic. March 12, 2020.
  6. Patel SV (expert opinion). Mayo Clinic. May 2, 2020.
  7. Wieben ED, et al. A common trinucleotide repeat expansion within the transcription factor 4 (tcf4, e2-2) gene predicts Fuchs corneal dystrophy. PLoS One. 2012;doi:10.1371/journal.pone.0049083.
  8. Patel SV, et al. Predicting the prognosis of Fuchs endothelial corneal dystrophy by using Scheimpflug tomography. Ophthalmology 2020; doi:10.1016/j.ophtha.2019.09.033.

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