Fuchs’ Dystrophy

Fuchs’ dystrophy (also known as Fuchs’ endothelial corneal dystrophy) is a progressive eye condition that affects the cornea – the clear front surface of the eye. It occurs when the inner layer of corneal cells (the endothelium) gradually loses function, allowing fluid to build up in the cornea. This can lead to corneal swelling, glare, and blurred vision that is often worse on waking.

At the Royal Buckinghamshire Hospital, we provide specialist assessment and ongoing management for patients with Fuchs’ dystrophy, supporting visual function and helping you understand the most appropriate treatment pathway.

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Stages of Fuchs’ Dystrophy

Fuchs’ dystrophy typically progresses slowly over time. It may be described in broad stages, such as:

• Early stage – subtle corneal changes with mild or intermittent symptoms
• Moderate stage – more noticeable corneal swelling and increasing visual fluctuation
• Advanced stage – persistent corneal swelling, reduced vision, and possible surface blisters (bullae) that can cause discomfort

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Common Causes of Fuchs’ Dystrophy

Fuchs’ dystrophy is usually age-related and can run in families. It is linked to gradual loss of endothelial cells, which normally keep the cornea clear by pumping fluid out.

Factors that may be associated with Fuchs’ dystrophy include:

• Family history (genetic predisposition)
• Increasing age (commonly developing later in adulthood)
• Co-existing eye conditions such as cataracts (both can contribute to changes in vision)

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Symptoms of Fuchs’ Dystrophy

Symptoms vary by severity, but commonly include:

• Blurred or misty vision, often worse in the morning
• Glare and haloes around lights (especially at night)
• Fluctuating vision that improves during the day (in earlier stages)
• Reduced contrast sensitivity (difficulty seeing in low light)
• Light sensitivity
• Gritty sensation, watering or irritation
• In advanced cases, painful corneal blisters and persistent blurring

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Diagnosis at Royal Buckinghamshire Hospital

Prompt, accurate diagnosis helps guide treatment and long-term planning. Assessment may include:

• Full consultant-led eye examination
• Slit-lamp examination to assess corneal health and characteristic changes
• Corneal thickness measurement to identify swelling
• Vision testing and assessment of glare impact on daily activities
• Checking for cataracts or other eye conditions that may affect symptoms and treatment decisions

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Treatment & Management

Treatment depends on how advanced the condition is and how much it affects your day-to-day vision.

Management may include:

• Lubricating eye drops to improve comfort
• Drops or ointments aimed at reducing corneal swelling, where appropriate
• Dry eye management and practical advice for glare and night driving
• Monitoring over time to track progression and visual function
• If symptoms become significant, discussion of surgical options (such as endothelial keratoplasty procedures) and the most appropriate onward pathway where needed

Your consultant will explain the safest, most effective approach based on your corneal health, vision requirements, and whether cataracts are also present.

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If you have symptoms that could indicate Fuchs’ dystrophy — particularly blurred morning vision, glare, or worsening clarity — contact Royal Buckinghamshire Hospital for assessment and guidance. There is no need to be registered with The Royal Buckinghamshire Hospital, or live locally.

If you have insurance which covers consultations, we can in most cases invoice the insurer directly. Where you are paying directly any costs will always be discussed.