Fuch's Dystrophy is caused by fluid gathering in the cornea.
Under normal conditions, the endothelial cells that line the cornea prevent fluids from accumulating within the cornea. This prevents the cornea from swelling and looking cloudy.
In Fuch's dystrophy these endothelial cells die off slowly and do not function properly leading to fluid accumulation within the cornea. This leads to the thickening of the cornea and burry vision.
Fuch's dystrophy can be inherited since it can occur in individual with a family history of the disease.
4 Making a Diagnosis
The following tests can help doctors (ophthalmologists) to diagnose Fuch's dystrophy:
Visual acuity test, in which the patient is asked to read letters and numbers on a chart to measure how well the patient can see and various distances.
Staging-determing the stage of the condition by examining the eye with an optical microscope (slit lump). This helps doctors to check if there are any pumps (guttae) on surface of the cornea.
Cornea pressure test, in which the pressure of the eye is tested. Doctors usually place eye drops that numb the eye and measure the pressure in the eye by briefly touching the cornea with a special instrument.
Corneal thickness- which is measured by a special instrument.
Corneal cell count- doctors use a special instrument to record the number, shape and size of cells lining the cornea.
Treatment for Fuch's dystrophy depends on the severity of the disorder. While mild cases require nonsurgical treatments, severe cases may require surgery.
Nonsurgical treatments include:
Eye drops or ointments that can help to reduce the amount of fluid in the cornea.
Soft contact lenses that can act as a "bandage" to relieve pain by smoothing out microscopic swelling on the cornea.
Surgical procedures for Fuch's dystrophy include:
Replacing the inner layer of the cornea. In this procedure only the back of the cornea is replaced with healthy tissue from a donor. It is performed under local anaesthesia in an outpatient setting.Two techniques can be used; Descemet stripping endothelial keratoplasty (DSEK) and Descemet membrane endothelial keratoplasty (DMEK).
Penetrating keratoplasty , in which the entire cornea is replaced with a healthy one from a donor.
6 Lifestyle and Coping
Lifestyle modifications are necessary in order to cope with Fuch's dystrophy.
The following techniques can help reduce glare and eye discomfort:
Applying over-the-couter salt solution (5 percent sodium chloride eyedrops or ointment).
Drying the eyes with a hair dryer as this can remove the excess fluid in the eye. It also helps to dry out microscopic swelling and blisters on the surface of the cornea. The hair dryer should be place at arm's length. Warm and not hot air should be directed across the face. This can be done two to three times daily.
Joining a support group can help people living with Fuch's dystrophy to cope with this condition.
7 Risks and Complications
The risks factors of developing Fuch's dystrophy include:
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