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Fuchs' dystrophy is a slowly
progressing disease that usually
affects both eyes and is slightly
more common in women than in men.
Although doctors can often see early signs of Fuchs' dystrophy in people in their 30s and 40s, the disease rarely affects vision until people reach their 50s and 60s.
Fuchs' dystrophy occurs when
endothelial cells gradually deteriorate without any apparent reason. As more endothelial cells are lost over the years, the endothelium becomes less efficient at pumping water out of the stroma. This causes the cornea to swell and distort vision.
Eventually, the epithelium also
takes on water, resulting in pain
and severe visual impairment.
Epithelial swelling
damages vision by changing the
cornea's normal curvature, and
causing a sight-impairing haze to
appear in the tissue.
Epithelial swelling will also
produce tiny blisters on the
corneal surface. When these
blisters burst, they are
extremely painful.
At first, a person with Fuchs'
dystrophy will awaken with
blurred vision that will
gradually clear during the day.
This occurs because the cornea is
normally thicker in the morning;
it retains fluids during sleep
that evaporate in the tear film
while we are
awake. As the disease worsens, this swelling will remain constant and reduce vision throughout the day.
When treating the disease, doctors
will try first to reduce the
swelling with drops,
ointments, or soft contact
lenses. They also may
instruct a person to use a hair
dryer, held at arm's length or
directed across the face, to dry
out the epithelial
blisters. This can be done
two or three times a day.
When the disease interferes with
daily activities, a person may
need to consider having a corneal
transplant to restore
sight. The short-term
success rate of corneal
transplantation is quite good for
people with Fuchs' Dystrophy
However, some studies suggest
that the long-term survival of
the new cornea can be a problem.
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