Methods Of Treating Fuchs' Dystrophy

Fuchs' dystrophy is an eye disease where the interior cell layer of the cornea or the endothelium undergoes degenerative alterations. This disease is most often caused by genetic factors, and it usually affects both of the eyes. Fuchs' dystrophy causes the reduced function of the endothelium, which is responsible for keeping the cornea clear by pumping excess fluid out. Swelling and clouding of the cornea occur because the fluid levels are not being managed. As Fuchs' dystrophy progresses, the swelling may result in epithelial bullae or blisters on the front of the cornea.

Common symptoms found in individuals who have Fuchs' dystrophy include eye pain, seeing colored halos around lights, poor vision in the morning that improves as the day progresses, foreign body sensation in the eye, problems with seeing at night, foggy or blurry vision, and sensitivity to light.

Cornea Transplant

A cornea transplant is a surgical procedure performed on the eye that replaces the clear front of the cornea. A full thickness corneal transplant may be needed if the diseased tissues have caused damage to the other surrounding corneal layers. The new cornea used in the transplant comes from a deceased organ donor. Fortunately, patients who need a corneal transplant typically do not have to wait very long for a donor like they would for a liver or kidney transplant. Most patients are sedated with medication to undergo this type of procedure, and it is done on an outpatient basis.

During a full corneal transplant, a cut is made through the whole thickness of the diseased or abnormal cornea to extract a small disk of tissue. The donor cornea is then cut to fit in the opening made in the recipient patient's cornea. A fine specialized thread is then used to sew and hold the new cornea in place. While this invasive procedure may take anywhere from several months to a couple of years to fully heal, it can restore vision in even the worst cases of Fuchs' dystrophy. In addition, any other intraocular surgery that may be needed can be done at the same time as a full corneal transplant. This type of surgery usually resolves most of the symptoms a patient is experiencing as a result of having Fuchs' dystrophy.

Soft Contact Lenses

When a patient has an advanced stage of Fuchs' dystrophy that is producing blisters or sores on the cornea, specialized soft contact lenses called therapeutic contact lenses may be used to help manage pain. Often, Fuchs' dystrophy patients will experience pain as a result of the blisters that form on the cornea from increased fluid build up in the eye. Bandage contact lenses can serve as a pressure patch on top of the affected cornea to help reduce pain. In addition, these special soft contacts can be used for the delivery of medications to the blisters on the cornea.

Bandage contacts are an ideal option to use over a traditional pressure patch because it allows for the application of drugs, and it gives the physician the opportunity to observe the condition of the eye without taking off the bandage. The patient also gets the chance to use the affected eye while it is being treated for blisters or sores, which would not be possible with the use of a traditional bandage.

Wraparound Sunglasses

Many patients with Fuchs' dystrophy will begin to experience colored halos and harsh glares in their vision as the disease progresses. One of the ways found to help with managing these types of vision issues is the use of wraparound sunglasses. These special sunglasses have a wraparound effect where the tinted lenses wrap all the way around each side of the head to the temples. This configuration ensures light cannot penetrate underneath the lenses and exacerbate the glares Fuchs' dystrophy patients experience with light sources.

Wraparound sunglasses can be obtained with or without a built-in corrective lens prescription. Many of these sunglasses available today also have specially made coatings that can help with further reducing light scattering and halos that frequently plague individuals who have Fuchs' dystrophy. Not only do these sunglasses help with the scattering of light, halos, and glares, but they are also beneficial for individuals who have a severe sensitivity to light as a result of their Fuchs' dystrophy.

Other Corneal Surgery

For individuals with Fuchs' dystrophy who may not be good candidates for the full corneal transplant procedure, there are other corneal surgery options available. Keratoprosthesis implantation is a surgical procedure in which the full thickness of the cornea is removed, and instead of being replaced by a donor cornea, it is replaced with an artificial cornea. Many individuals who have Fuchs' dystrophy who undergo keratoprosthesis implantation have had prior complications with a corneal transplant. Unlike a full transplant from a human donor, keratoprosthesis does not carry the risk of donor tissue rejection.

Artificial corneas are an ideal long-term solution that can provide a Fuchs' dystrophy patient with normal vision as long as the rest of the eye is not severely damaged. Some individuals with Fuchs' dystrophy may also experience the development of cataracts. Cataract surgery can be performed on individuals with both cataracts and Fuchs' dystrophy, though once the disease has progressed to a particular stage, a combination surgical procedure to resolve cataracts and replace the cornea may be required to restore normal vision.

Medicated Eyedrops

In the beginning stages of Fuchs' dystrophy, an individual may be prescribed medicated eyedrops to help them manage their symptoms. The eye drops used to treat Fuchs' dystrophy primarily focus on relieving the intraocular pressure causing vision changes and other symptoms. In mild cases of Fuchs' dystrophy, swelling of the eye is the only issue causing an individual to experience symptoms. The specialized eye drops are dropped into the eye three to four times a day to help the eye drain excess fluids.

Most of these eye drops contain a sodium chloride solution of either two or five percent. In certain cases where inflammation is involved, prescribed eye drops containing steroids may be needed. These eye medications may also be used in the form of an ointment applied to the cornea at bedtime and upon waking up in the morning. This type of treatment can help manage the early stages of Fuchs' dystrophy, but it does not stop the condition's natural progression.