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Ophthalmology and Visual Sciences

Fuch's Endothelial Corneal Dystrophy

Fuch's Endothelial Corneal Dystrophy

Category(ies): Cornea
Contributor: Brendan K. Penaluna, Jordan Graff, MD, Andrew Doan, MD, PhD

Expanded text by Brendan K. Penaluna, May 5, 2017

Fuchs' dystrophy is an example of a posterior corneal dystrophy. Thickening of the Descemet's membrane and defects of endothelial cell number and shape may result in progressive obscuration of vision. Cataract surgery in the setting of Fuch's dystrophy may rarely result in the decompensation of the corneal endothelium, creating an opportunity for the worsening of Fuchs' dystrophy. In this image of a patient with Fuchs' dystrophy post-cataract surgery, endothelial degeneration and subsequent edema and scarring can be appreciated as the white, hazy opacity contrasting against the brown iris and black of the pupil.[1]

Contributor: Jordan M. Graff, MD

Slit lamp of cornea patient with Fuch corneal dystrophy
Slit beam view of cornea in a patient with Fuch's corneal dystrophy. By overlying the slit beam with the reflected image of the tungsten filament on the cornea, the examiner can highlight the endothelial surface just to the side of the combined bright spot in the slit beam.
corneal endothelial guttata
Here, the characteristic corneal endothelial guttata are well visualized.

Contributor: Andrew Doan, MD, PhD

Microscopic look at loss of endothelial cells
specular microscopy with loss of endothelial cells
References:
  1. Biswell R. Chapter 6. Cornea. In: Riordan-Eva P, Cunningham ET, Jr. eds. Vaughan & Asbury's General Ophthalmology, 18e New York, NY: McGraw-Hill; 2011. http://accessmedicine.mhmedical.com/content.aspx?bookid=387§ionid=40229323. Accessed April 17, 2017.

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Ophthalmic Atlas Images by EyeRounds.org, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.