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Blurry Vision? It Could Be Fuchs’ Dystrophy
This genetic eye disease starts to cause problems in your later years. Here’s what you need to know about symptoms and treatments
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Norine Kirby, 69, knew blurry vision is a typical temporary side effect after cataract surgery. But when she still couldn’t see clearly several weeks after her February surgery, Kirby suspected something else was wrong.
“It was like I was looking through a snow globe,” says Kirby, of Carroll County, Maryland. “Everything was blurry.”
Norine Kirby, right, with her daughter Samantha Kirby. Kirby is being treated for the genetic eye disease Fuchs' dystrophy.
Karen Rainier Photography
When Kirby went back to her ophthalmologist, she was diagnosed with Fuchs’ dystrophy, a genetic eye disease that affects the cornea.
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Although Fuchs’ dystrophy is a condition that patients are born with, it typically causes vision problems that develop later in life.
Cataract surgery doesn’t cause the disease, but it can exacerbate symptoms, says Zeba Syed, M.D., an ophthalmologist who specializes in cornea, cataract and refractive surgery at Wills Eye Hospital in Philadelphia. It’s not uncommon for patients to learn they have the disease after the surgery, Syed says.
About 4 percent of Americans over age 40 have Fuchs’ dystrophy, according to the National Library of Medicine. Women are two to four times more likely to develop Fuchs’ than men. The condition is named after Austrian ophthalmologist Ernst Fuchs, who first described it in the 1920s.
What causes Fuchs’ dystrophy?
When you have Fuchs’ (pronounced “fooks”) dystrophy, the cells responsible for pumping extra fluid out of your eyes start to die off. As the disease progresses, fluid builds up in your cornea, causing swelling and cloudy vision, Syed says.
“The cornea is like a sponge that can get swollen,” Syed says. “You want it to be clear and compact. When it’s swollen, it gets cloudy, and patients can’t see.”
The disease can also cause small blisters to form on your cornea that can break and cause eye pain.
Fuchs’ dystrophy usually affects both eyes. Although it’s a genetic disease, some patients don’t know anyone in their families who has had it, Syed says.
Symptoms of Fuchs’ dystrophy
Most people who have Fuchs’ start to develop symptoms around age 50 or 60, but it can happen earlier or later, says Albert Cheung, M.D., an ophthalmologist who specializes in corneal and cataract care at Virginia Eye Consultants in Norfolk, Virginia.
The disease is most often diagnosed during an annual eye exam, but signs can be subtle, so in some patients it’s not detected until symptoms develop, Cheung says.
Courtesy Mayo Clinic
Here are common symptoms of Fuchs’ dystrophy.
- Vision that’s worse in the morning: In the early stages of the disease, fluid builds up in your eye only in your sleep, when your eyes are closed, Cheung says. So blurriness tends to get better as the day goes on.
- Cloudy or hazy vision: In addition to overall cloudiness, patients tend to have trouble with contrast. You may need bright light to see print, or notice that colors are not as vibrant.
- Glare, halos or starbursts: You may see halos or spiderweb starbursts around lights or have trouble seeing at night because of the glare. Some patients report ghost or shadow images.
- Discomfort in bright light: You may notice that your eyes are more sensitive to light, and you find yourself needing to wear sunglasses outside.
- Sandy or gritty feeling in both eyes: Fuchs’ blisters can cause you to feel like you have something in your eyes.
Treatments for Fuchs’ dystrophy
Early stages of Fuchs’ dystrophy are treated with drops and ointments that help to reduce the swelling, Syed says.
“It’s basically a saltwater drop,” Syed says. “It absorbs fluid from whatever surface it touches. We often do it at bedtime, and it works well for mild Fuchs’.”
Once Fuchs’ gets more advanced, most patients need a partial corneal transplant. It’s an outpatient procedure in which a doctor strips off the old tissue and cells that aren’t working, replacing them with new tissue from a compatible donor.
A small number of patients who have limited disease may be able to opt for a different type of surgery known as Descemet stripping only (DSO), Syed says. That’s when a doctor removes the diseased tissue and cells but does not replace them with transplanted tissue. Instead, the patient’s own healthy peripheral cells grow to fill the gap.
Both procedures are effective, Syed and Cheung say.
As for Kirby, she knows she may need to have surgery one day, but so far she says she is doing well using drops and ointments a few times a day.
“It has drastically improved my vision,” she says. “I’ve been able to go about life as normal. I can read now, and I’m not getting dizzy.”
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