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Fuchs dystrophy affects the cornea, which is the front part of the eye. It is an inherited problem with the pump layer of cells, which are responsible for pumping fluid back into the eye. Fuchs’ dystrophy is common and normally affects people in middle age or later life. The typical early symptom is ‘morning misting’ – patients find that their vision is misty on waking, but clears during the day.


As the condition progresses, Fuchs' dystrophy symptoms, which usually affect both eyes, might include:

  • Glare: which can decrease your vision in dim and bright light.

  • Blurred vision:  which occurs in the morning after awakening and gradually improves during the day. As the disease progresses, blurred vision either can take longer to improve or doesn't improve.

  • Pain or grittiness from tiny blisters on the surface of your cornea.

Other symptoms can include distorted vision, sensitivity to light, difficulty seeing at night and seeing halos around lights


Normally, the cells lining the inside of the cornea (endothelial cells) help maintain a healthy balance of fluids within the cornea and prevent the cornea from swelling. But with Fuchs' dystrophy, the endothelial cells gradually die, resulting in fluid build-up (edema) within the cornea. This causes corneal thickening and blurred vision.

Fuchs' dystrophy can be inherited. The genetic basis of the disease is complex — family members can be affected to varying degrees or not at all.

Risk factors

Factors that increase your risk of developing Fuchs' dystrophy include:

  • Sex. Fuchs' dystrophy is slightly more common in women than in men.

  • Genetics. Having a family history of Fuchs' dystrophy increases your risk.

  • Age. Although there's a rare early-onset type of Fuch's dystrophy that begins in childhood, typically the disease starts in the 20s and 30s, with symptoms developing in the 50s and 60s.

  • Smoking and having diabetes might also put you at higher risk of the disease

  • Glare and sensitivity to light

  • Eye pain

  • Foggy or blurred vision

  • Seeing coloured halos around lights

  • Difficulty seeing at night

  • Poor vision upon awakening that may improve later in the day

  • A feeling that something is in your eye (foreign body sensation)


Good vision can be restored in patients with Fuchs’ dystrophy and other causes of corneal endothelial failure by corneal transplantation.

Since 2000, selective corneal transplantation techniques have been developed, which allow surgeons to replace the damaged endothelial layer with healthy tissue through a small incision in an operation similar to modern cataract surgery.

Different versions of this operation called DSAEK or DMEK are available to suit different patients. These ‘keyhole’ corneal transplantation operations can be performed under local anaesthetic, can be repeated if necessary, and can quickly improve vision.

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