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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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