Fuchs endothelial corneal dystrophy is a slow progressive, bilateral eye condition that primarily affects females. It has four stages: corneal guttata, edema, bullous keratopathy, and scarring. The disease is characterized by a decrease in endothelial cell count and density over time. Early stages are asymptomatic, but later stages involve pain, decreased vision, and corneal scarring. Treatment options include lubricants, medications, and penetrating keratoplasty for advanced cases.

1. Fuchs endothelial corneal
dystrophy
Presented by:-- Gauri Shankar Saini
MBBS

2. Onset and course
• Aka endoepithelial corneal dystrophy
• Slow progressive, bilateral conditions
• Females > males
• Inheritance (autosomal dominant or sporadic)
• Genetic locus is 13p.

3. Clinical features
1. Stage of corneal guttata
2. Oedematous or endothelial decompensation
3. Stage of bullous keratopathy
4. Stage of scaring

4. Stage of cornea guttata
• Hassall henle type excrescence ( central cornea)
• Beaten mettal appearance
• Asymptomatic stage

5. Oedematous stage
• Early stromal oedema and epithelial dystrophy
• Blurring of vision

7. Stage of bullous keratopathy
• Marked epithelial oedema with formation of bullae
• when bulle rupture cause pain, discomfort, irritation, decreased
visual acuity

8. Stage of scaring
• Bullae replace by scar tissue
• Opaque and vascularized cornea
• Complicated by occurance of infection and glaucoma

9. Specular microscopy
• Decreased endothelial cell count
• Increased average cell diameter
• Decreased hexagon
• Increased variations in size

10. Treatment
• 5% NaCl
• Warm air
• 0.5% timolol
• Soft contact lenses
• Penetrating keratoplasty