Fuchs’ Dystrophy

February 2, 2017

Fuchs’ (fooks) dystrophy is a progressive hereditary disease affecting the part of the eye called the cornea, the clear, round dome covering the eye’s iris and pupil, with symptoms that often become noticeable after the age of 50.

The cornea is the clear window on the front of the eye and is comprised of three main layers—the epithelium, stroma and endothelium. The purpose of the epithelium is to act as a barrier to protect the cornea from dust, debris and bacteria. The stroma is the middle layer and makes up 90% of cornea thickness, mostly of collagen and other structural materials. Its purpose is to give the cornea its strength and dome-like shape. The endothelium is just one layer of cells located on the Descemet membrane (blue line in illustration above) and its job is to provide the appropriate balance of fluid in the cornea, keeping it thin and crystal clear.

Fuchs’ dystrophy (named after Dr. Fuchs) is an inherited condition that affects the delicate inner layer (endothelium) of the cornea. Patients with Fuchs’ dystrophy have endothelial cells that –

  • Do not function as efficiently as normally
  • Age and deteriorate more rapidly than normal cells

Fuchs’ dystrophy affects both eyes and is slightly more common in women than men. On average, half of the family members of an affected person may carry or suffer from the condition. The exact cause of Fuchs’ dystrophy is unknown. Hereditary, hormonal and inflammatory factors probably all play a role.

Causes

Fuchs’ dystrophy affects the thin layer of cells that line the back part of the cornea. These cells help pump excess fluid out of the cornea. As more and more cells are lost, fluid begins to build up in the cornea, causing swelling and a cloudy cornea.

At first, fluid may build up only during sleep, when the eye is closed. As the disease gets worse, small blisters may form. The blisters get bigger and may eventually break, causing eye pain. Fuchs’ dystrophy can also cause the shape of the cornea to change, causing further vision problems.

Free radicals can damage the eyes – They are formed when the ultraviolet and blue light of sunlight passes through the crystalline lens. Free radicals are also natural byproducts of metabolism. These highly reactive chemicals cause oxidation, and can destabilize healthy cells in the back of the eyes. Free radical damage is accelerated by smoking, chronic fatigue, and having a compromised immune system.

Nutritional Deficiencies and poor digestion – Often sufferers of macular degeneration are deficient in a number of the nutrients that are essential to eye health: essential fatty acids, lutein, zeaxanthin, taurine, antioxidants, bioflavonoids, zinc, selenium, and vitamin B-complex.

Heredity – The genetic basis of the disease is complex — family members can be affected to very variable degrees, and sometimes not at all.

Risk Factors

Factors that increase the risk of developing Fuchs’ dystrophy include –

  • Being female, as Fuchs’ dystrophy is slightly more common in women than in men
  • Having a family history of Fuchs’ dystrophy
  • Being over 50

Symptoms

Because Fuchs’ dystrophy is related to a build-up in fluid in corneal tissue, symptoms can be worse on humid or rainy days and better on dry days or in dryer climates, such as an airplane or desert.

Generally, symptoms may include –

  • Hazy or cloudy vision;
  • Glare around certain objects (especially light sources);
  • Halos around certain objects;
  • Reduced visual acuity;
  • Reduced ability to discern contrasts;
  • Difficult driving at night;
  • Fluctuations in vision, especially in the early morning. As the condition advances, however, these fluctuations become more persistent throughout the day;
  • Pain in the eye, if the condition is more advanced and blisters have formed.

Fuchs’ dystrophy usually develops over two stages –

Stage 1 may produce no symptoms or only mild symptoms. In this early stage, the swelling of the corneal cells usually occurs in the morning then tends to clear as the day progresses. Vision is worse in the morning because closing your eyes during sleep keeps moisture from evaporating out of the cornea.

Once the disease has progressed to Stage 2, vision no longer gets better later in the day. People with Stage 2 Fuchs’ dystrophy may have pain and be sensitive to light. Extreme climate conditions, such as high humidity, can worsen the condition.

Complications

  • Eye pain
  • Eye sensitivity to light
  • The feeling that something is in your eye when there is nothing there
  • Vision problems such as seeing halos or cloudy vision
  • Worsening vision

Treatment

Use of eye medication – Eyedrops or ointments can reduce the amount of fluid in the cornea.

Drying eyes – Use a hair dryer and hold it at arm’s length. Direct warm — not hot — air across your face two or three times a day to evaporate excess fluid in the cornea and dry out blisters.

Wearing soft contact lenses – Soft contact lenses can improve vision and reduce discomfort.

Corneal transplant – This surgical procedure, also known as keratoplasty, replaces damaged cornea tissue with healthy tissue from a donor. There are many types of corneal procedures. Some procedures replace only a few thin layers of the cornea, while others replace the entire cornea. For Fuchs’ dystrophy, an increasingly common procedure replaces only the deep layers of the cornea, including the endothelium. This is sometimes referred to as endothelial keratoplasty or posterior lamellar endothelial keratoplasty.

Alternative Treatment

Potassium – One of the many nutrients that is essential for human life is potassium. Potassium is an electrolyte which means it is a mineral with an electric charge that is present in blood and other fluids in the body. This mineral is necessary for growth, muscle function, electrical activity of the heart, nerve impulse transmission and acid-base balance. Potassium is one of the important components that comprise tear film.

Natural foods rich in vitamin A, vitamin C, vitamin E, carotenoids and many other phytonutrients, such as inositol, are vital in the diet for good vision and to keep the eye healthy. This will fight infections, help to recover from illnesses or surgery on the eyes and protect against many diseases that happen due to aging.

Foods rich in rutin can prevent and treat glaucoma and cataracts as this flavonoid acts on the circulatory system to strengthen blood vessels, especially the tiny capillaries in the eyes. Foods rich in rutin should be consumed along with foods rich in vitamin E, vitamin C and hesperidin.

Maqui berry is a ‘super berry’ from the Chile and Argentinean regions of South America which contains the highest amount of antioxidants and anti inflammatory compounds than any other known natural food. Regular consumption can protect against age related macular degeneration and improve the health of the eyes.

Pumpkin seeds – a handful a day will nourish the eyes.

Raw Juice Therapy can successfully treat many eye conditions and help to relieve and prevent others.

Lutein and zeaxanthin are very important because they help protect the retina from damage caused by the sun’s harmful ultraviolet (UV) rays and high-energy visible (HEV) light. Prolonged exposure to UV and HEV rays may damage the retina and increase the risk of developing macular degeneration. Lutein and zeaxanthin also may reduce the risk of cataracts later in life.

Bilberry (Vaccinium myrtillus, blueberry) Contains nutrients that protect eyes from eyestrain or fatigue and can improve circulation to the eyes.

 

Reference –

http://www.cornea.org/Learning-Center/Conditions-Research-Areas/Fuchs-Dystrophy.aspx

http://www.fuchs-dystrophy.org/story.html

https://www.willseye.org/video/fuchs-dystrophy

http://www.moorfields.nhs.uk/condition/fuchs-dystrophy

http://www.aao.org/eye-health/tips-prevention/what-is-fuchs-dystrophy

 

 

http://emedicine.medscape.com/article/1193591-overview

http://www.allaboutvision.com/conditions/fuchs-corneal-dystrophy.htm

http://www.mayoclinic.org/diseases-conditions/fuchs-dystrophy/basics/definition/con-20023893

https://www.nlm.nih.gov/medlineplus/ency/article/007295.htm

http://www.hopkinsmedicine.org/wilmer/conditions/Fuchs/about/symptoms.html

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