Fuch’s Endothelial Dystrophy

Question 1

What is Fuch’s Corneal Dystrophy?

Answer 1

A condition where the corneal endothelium becomes damaged, causing the water pump mechanism to fail, leading to corneal thickening and swelling.

Question 2

What are the signs of Fuch’s Corneal Dystrophy?

Answer 2

Reduced VA, Beaten metal appearance of the corneal endothelium, Fine pigment on endothelium, Cystic epithelial oedema, Stromal oedema, Stromal scarring.

Question 3

What are the symptoms in early-stage Fuch’s Corneal Dystrophy?

Answer 3

None in the early stage and rare symptoms for individuals under 50.

Question 4

What are the symptoms of advanced Fuch’s Corneal Dystrophy?

Answer 4

Glare and blurred vision, especially on waking (due to stromal oedema), Diurnal changes in refraction (myopic on waking), Sharp pain when epithelial bullae rupture.

Question 5

What is the main cause of blurred vision in Fuch’s Corneal Dystrophy?

Answer 5

Stromal oedema, which worsens overnight, causing blurred vision and glare, especially in the morning.

Question 6

How can Fuch’s Corneal Dystrophy affect refraction?

Answer 6

It can cause diurnal changes, leading to temporary myopia (nearsightedness) upon waking.

Question 7

What causes sharp pain in Fuch’s Corneal Dystrophy?

Answer 7

The rupture of epithelial bullae.

Question 8

What is the recommended management for Fuch’s Corneal Dystrophy?

Answer 8

Routine referral to HES, Ocular lubricants for symptom relief, Ocular sodium chloride applied in the morning, with variable dosage.

Question 9

What is the role of sodium chloride in managing Fuch’s Corneal Dystrophy?

Answer 9

It helps reduce corneal swelling, especially when applied in the morning.

Question 10

At what age do symptoms of Fuch’s Corneal Dystrophy typically begin to appear?

Answer 10

Symptoms are rare before the age of 50 and are typically absent in the early stages.