Good Hope, Heartlands, and Solihull Eye Clinics

Fuchs Corneal dystrophy

David Kinshuck

 

What is Fuchs corneal dystrophy?

The condition is described well here at St Lukes. I have given a very brief description below.

 

Anatomy

The cornea is the front 'window' of the eye. It is clear, just like glass.  On the back surface of the cornea there is a single layer of cells, the 'endothelium'.

This endothelium contains a layer of cells that  'pump' fluid out of the cornea. (The fluid enters naturally.)

If you have this condition, this layer of cells becomes damages as you get older. The 'pump' system  stops working, and then cornea becomes thick and waterlogged with fluid. This makes the cornea cloudy, like frosted glass, and you will have difficulty seeing.
See the St Lukes page for more details.

 

Treatment

There is no cure. 5% saline drops or ointment may help..they remove fluid from the waterlogged cornea. They can be used as required, quite often if they improve vision. (5% saline is 5 times the strength of normal saline.)

  • from Moorfields Pharmaceuticals
    • Sodium Chloride 5% ointment. 5g (I am not sure this is still available, but these 5% Sodium Chloride drops below will be effective)
    • PF Drops Sodium Chloride 5%, preservative free, multi-dose
  • Lubricants can help
  • treat ruptured bullae
  • a hairdryer in the morning can help

By removing the fluid, the cornea may become clearer and the sight will be less blurred. They are always worth a try, perahps 4 times a day for a week, and if they help they can be safely used long term.

 

Surgery ... corneal graft / corneal transplant

If cornea is very cloudy, you may need a corneal transplant if you want to see clearly again. The patient cornea is replaced in an operation with a donor cornea.

There are newer operations, where only one layer of the corneal needs transplanting. These new operations are being carefully researched.

For professionals: refer patients to the corneal team early, before there is corneal scarring, and the results of surgery will be better.

There is now a 'patient group' for people in the UK with this condition.

Cataract surgery

  • This can make the condition worse, but is usually safe
    • if preacutions are taken
    • if the oedema is <620 microns abd tere is no stromal oedema
  • otherwise a corneal transplant such as a DSEK may be needed

Genes & research