Fuchs' dystrophy

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Etiology

endothelial cells gradually deteriorate without any apparent reason
as more endothelial cells are lost over the years, the endothelium becomes less efficient at pumping water out of the stroma
this causes the corneal edema & distortion of vision
corneal edema in later phases, resulting in pain & severe visual impairment.
epithelial swelling damages vision by changing the cornea's normal curvature, & causing a sight-impairing haze to appear in the tissue.
epithelial swelling will also produce tiny blisters on the corneal surface
when these blisters burst, they are extremely painful.

slowly progressing disease
usually affects both eyes
initially, patients awaken with blurred vision that will gradually clear during the day
- this occurs because the cornea is normally thicker in the morning
- it retains fluids during sleep that evaporate in the tear film while we are awake
as the disease worsens, this swelling will remain constant & reduce vision throughout the day

reduce the swelling with drops, ointments, or soft contact lenses
use a hair dryer, held at arm's length or directed across the face, to dry out the epithelial blisters 2-3 times a day
corneal transplant: short-term success is good