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Understanding Fuchs' Dystrophy: How Scleral Lenses Can Help

Explore the benefits of scleral lenses for Fuchs' dystrophy treatment. Discover how your eye doctor can improve your vision.

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Understanding Fuchs' Dystrophy: How Scleral Lenses Can Help Optometrist
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In the United States, around 70% of patients with fuchs' dystrophy experience significant vision loss, greatly impacting their quality of life.

At Amplify EyeCare, we have encountered numerous patients grappling with various corneal dystrophies. Among them, fuchs' dystrophy is particularly common. This debilitating eye disease can greatly impact the quality of life, including the ability to perform everyday activities like driving. We have found scleral lenses to be a beneficial treatment option for this condition.

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What is Fuchs' Dystrophy?

Fuchs' dystrophy, also referred to as fuchs' corneal dystrophy or fuchs' endothelial dystrophy, is a degenerative disorder affecting the cornea's innermost layer, the endothelium. This layer keeps the cornea clear and healthy, and any deterioration can lead to vision impairment and discomfort. It typically affects people in their 50s and 60s.

Fuchs' Dystrophy Treatment

Fuchs' Dystrophy Treatment

Studies indicate that fuchs' dystrophy is responsible for nearly 20% of all cornea-related transplants in the U.S.

Treatment for fuchs' dystrophy varies based on the severity of the condition. In early stages, treatment often involves managing symptoms. For instance, ointments and eye drops can alleviate eye discomfort, while certain changes in lifestyle may slow disease progression.

However, as the disease advances and the cornea becomes increasingly swollen and scarred, a more decisive treatment is necessary. Historically, the most common approach has been corneal transplantation. Despite its effectiveness, the procedure is invasive and carries potential risks, including rejection of the transplant.

Today, a more advanced treatment has become the gold standard for managing fuchs' dystrophy – scleral lenses.

Fuchs' Dystrophy Treatment

Fuchs' Dystrophy Treatment

Scleral lenses have emerged as a promising solution for patients with Fuchs' dystrophy. Unlike regular contact lenses, scleral lenses vault over the entire corneal surface and rest on the white part of the eye, the sclera. This design reduces irritation and provides a smooth optical surface, which can significantly improve vision in individuals with corneal irregularities.

Benefits of Scleral Lenses

There are several key benefits of using scleral lenses for Fuchs' dystrophy:

Improved vision: These lenses correct vision distortions caused by an irregular cornea and offer a clearer, more focused visual experience.

Comfort: Scleral lenses are designed to fit securely and comfortably on the eye, reducing the friction and irritation often associated with regular contacts. Scleral lenses also sit on the white part of the eye, the sclera, which is less sensitive. Lastly, Scleral lenses use a reservoir of saline, which keeps the eyes moist and hydrated all day. 

Protection: The large size of scleral lenses provides a protective barrier, preventing dust and debris from getting under the lens.

Long-term solution: Scleral lenses are durable and can be a long-term treatment option for fuchs' dystrophy, providing relief and improved vision for extended periods.

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Recognizing the Symptoms of Fuchs’ Dystrophy

Recognizing the Symptoms of Fuchs’ Dystrophy

Recognizing the symptoms of fuchs' dystrophy is crucial in diagnosing the disease early. The most common fuchs' dystrophy symptoms include:

Causes and Risk Factors of Fuchs' Dystrophy

The exact cause of fuchs' dystrophy is still unclear. However, research indicates that it is likely due to a combination of genetic and environmental factors.

Genetic Factors

Fuchs' dystrophy is often inherited, indicating a strong genetic component. Certain mutations in the COL8A2 and TCF4 genes have been associated with this condition. If you have a family history of Fuchs' dystrophy, it may increase your risk of developing the condition.

Aging

While Fuchs' dystrophy can occur at any age, it is more common in individuals over 50 years old. Aging can lead to a gradual decline in the number and function of endothelial cells, increasing the risk of Fuchs' dystrophy.

Gender

Fuchs' dystrophy affects women almost twice as much as men

Interestingly, Fuchs' dystrophy appears to be more common in women. While the reasons for this gender disparity remain unknown, it underscores the importance of regular eye exams, especially for women over 50.

Fuchs' Dystrophy Treatment
Fuchs' Dystrophy Treatment

Fuchs' Dystrophy and Driving

One common concern amongst patients with fuchs' dystrophy relates to driving. Blurred vision and sensitivity to glare can significantly affect driving capabilities, particularly during the night or in bright sunlight. As an optometry clinic, we strongly recommend patients to have regular eye examinations to ensure their vision meets the required driving standards.

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Common Questions

The exact cause of Fuchs' dystrophy isn't entirely clear. However, it's known to be an inherited disease with a strong genetic component. Mutations in certain genes such as COL8A2 and TCF4 have been linked to this condition. In Fuchs' dystrophy, the cells in the cornea's inner layer, the endothelium, begin to deteriorate for reasons not entirely understood. This deterioration hampers the cornea's ability to pump out excess fluid, leading to swelling and vision issues characteristic of the disease.
Fuchs' endothelial dystrophy typically progresses in four stages: Asymptomatic: In the early stage, there are changes at the cellular level, but the patient may not experience symptoms. Symptomatic: The patient begins to exhibit symptoms like blurry vision, especially in the mornings, and eye discomfort. Edema: In this stage, fluid buildup in the cornea leads to more significant vision impairment, including hazy vision and sensitivity to light. Late-stage or 'Crisis': This final stage involves severe corneal swelling, scarring, and vision loss. Painful blisters may form on the cornea's surface.
The diagnosis process for Fuchs' eye disease involves a comprehensive eye exam. Our optometrist will use a slit lamp, a device that shines a thin sheet of light into the eye, to examine the cornea and detect any abnormalities. The exam may also include a corneal pachymetry, a non-invasive test that measures the thickness of your cornea, and an endothelial cell count, which determines the number and condition of cells in the cornea's endothelial layer. Our optometrist may also perform an OCT test which takes a high definition image of the eye.
Fuchs' dystrophy can start at any age, but it's typically diagnosed in people in their 40s and 50s. However, the disease often doesn't affect vision until it has significantly progressed, usually in people aged 60 and older. Regular eye exams are essential for early detection and management of the condition, particularly for individuals with a family history of the disease
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Summary

Fuchs' dystrophy is a prevalent and debilitating eye disease affecting the cornea's innermost layer, typically found in people in their 50s and 60s. In the United States, approximately 70% of individuals with this condition experience significant vision loss, which impacts their daily lives, including tasks such as driving. Amplify EyeCare has identified scleral lenses as a promising treatment option for Fuchs' dystrophy. These lenses cover the entire corneal surface, reducing irritation and enhancing vision for those with corneal irregularities. The exact cause of Fuchs' dystrophy remains unclear, but it's likely due to a mix of genetic and environmental factors. The disease seems to affect women nearly twice as much as men, and it's often inherited, implying a strong genetic component. Symptoms include eye pain, blurry vision, light sensitivity, and problems with color perception. Regular eye exams are crucial for early detection and management of the condition.

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