Fuch's Endothelial Dystrophy (FED)
Fuch’s Endothelial Dystrophy occurs when cells are lost from the back layer of the cornea, known as the endothelium. The cornea is the clear, front portion of the eye. The endothelium is in charge of regulating the amount of water that gets into the cornea. When cells are lost from the endothelium, it allows water to push its way into the cornea and cause it to swell.
What causes Fuch's Endothelial Dystrophy?
Fuch’s is a genetic condition that generally starts in a person’s 50s. This genetic condition causes small deposits to form within the cornea called guttata. Guttata causes endothelial cells to be lost which in turn lead to fewer cells controlling the amount of water entering the cornea.
Symptoms of FED
The most common symptom is blurred vision in both eyes that cannot be corrected with glasses and contact lenses that worsens over time. Often it is reported as being worse in the morning. Glare may also be experienced. These symptoms are a direct result of the cornea swelling from the increase in water. In severe cases, there may be pain associated with it due to bullae rupturing. Bullae are microscopic water pockets that form within the middle layers of the cornea (stroma) and are similar to blisters.
How is it Treated?
Often times this condition will be monitored until vision is affected. Once vision becomes significantly blurred, an eye drop may be used. This eye drop is essentially a salt water solution. The idea is that this solution will cause water to be pulled out from the cornea and into the tears. This loss of water from the cornea will decrease the swelling and allow it to return to a more normal thickness.
In severe cases, surgery may be warranted if the vision has decreased drastically and the above mentioned eye drop does not help. In such a case, a descemet stripping endothelial keratoplasty (DSEK) may be considered or a treatment very similar to this one. A DSEK is a surgery where descemet’s layer of the cornea is surgically removed and a new layer is transplanted into the cornea. Descemet’s layer is where the guttata are formed in FED.
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