Fuchs Endothelial Corneal Dystrophy

Fuchs endothelial corneal dystrophy (FECD) is a progressive eye disorder that affects the cornea, which is the clear dome-shaped surface at the front of the eye. It is characterized by the gradual deterioration of the endothelium, the innermost layer of the cornea responsible for maintaining its clarity and hydration.

Causes and Risk Factors

FECD is a genetic disorder, and it is often inherited in an autosomal dominant pattern, meaning that a single copy of the mutated gene is enough to cause the condition. The exact causes of FECD are not fully understood, but it is believed to be related to mutations in several genes, including the TCF4 gene. Risk factors for developing FECD include:

• Age: FECD typically affects people over the age of 50
• Family history: Having a family history of FECD increases the risk of developing the condition
• Gender: Women are more likely to develop FECD than men

Symptoms

The symptoms of FECD can vary from person to person, but common signs and symptoms include:

• Blurred vision
• Double vision
• Sensitivity to light
• Pain or discomfort in the eye
• Redness or swelling of the eye
• Corneal edema (swelling of the cornea)

Diagnosis

FECD is typically diagnosed through a combination of:

• Slit-lamp examination: A specialized microscope that allows the doctor to examine the cornea and endothelium in detail
• Corneal pachymetry: A test that measures the thickness of the cornea
• Specular microscopy: A test that uses a special microscope to visualize the endothelial cells
• Genetic testing: To identify mutations in genes associated with FECD

Treatment and Management

Treatment for FECD depends on the severity of the condition, but may include:

• Medications to reduce corneal edema and improve vision
• Corneal transplantation: To replace the damaged cornea with a healthy donor cornea
• Endothelial keratoplasty (EK): A surgical procedure that replaces the diseased endothelium with a healthy donor endothelium

Prognosis

The prognosis for FECD varies depending on the severity of the condition and the effectiveness of treatment. With proper management, many people with FECD can maintain good vision and avoid significant complications. However, in advanced cases, FECD can lead to significant vision loss and blindness.