Featured Article for June 30, 2020
Fuchs’ Endothelial Dystrophy
In the early stages of Fuchs’ dystrophy loss of endothelial cells and small excressences of Descemet’s membrane can be seen. These excressences are called “guttata” and look similar to microscopic mushroom caps on the on endothelial surface of the cornea. These guttata are visible on slit lamp exam. The endothelial cells may appear larger than average and may have embedded pigment. With time fluid from the anterior chamber will collect in the corneal stroma increasing the thickness of the corneal stroma causing reduced vision. With more advanced disease the swelling, or edema, collects in the epithelial layer of the cornea causing small blisters called bullae. With chronic edema, fibrotic tissue will form in the subepithelial space and invade the cornea leading to further corneal opacification. Permanent scar tissue eventually will develop in the cornea that will require surgery to remove.
