Newly diagostics with Fuchs dystrophy, is it severe?

[sunflowerla]

Hi all. I was just diagnosed with Fuchs dystrophy yesterday when I visit a corneal specialist. It is really frustrating bc I am just in my 30's, and the doctor said there's no way to stop it and finally I will need a transplant or surgery in my 50's or 60's. My cell count is very low for my age, about 2070 for both eyes, but normal thickness. Currently I don't have any strong signs of the disease but just see glares of street lights at night. I am wondering how much is the chance that I don't get so severe with the problem in 20 years, or how long does it take for my situation to feel pain or needs to go surgery?

Thank you for any answer.

[sunflowerla]

Thank you very much Dr. Hagan for your reply!

Although the absolute cell number is not so low to cause any vision problem in daily life yet, but I'm wondering, if this cell number at my age (35) could be any indicator of when I might be near the bottom line of 800 cell number?

I was going to comment on your answer so you could notice my follow up question, but the button doesn't work... looking forward for your professional opinion!

[JohnHaganMD]

I think it unlikely you will have a problem.  The progressive, type of Fuchs runs in families. There are generations of people that develop problems early have cell #'s in 900 in their 20's and older members needed corneal transplants and more recently the DSEAK procedure.  Spontaneous Fuchs with a few drusen doesn't usually progress.  That cell # would be normal for 30's.  Other important thing is the # of guttatta  (few or many) and mesurement of corneal thickness (corneal pachyometry)     If your answer doesn't post make a second post with just a single word and hit submit comment. Both answers will appear. It is some software problem they have been unable to fix over 15 years.

[sunflowerla]

Thank you Dr. Hagan!

I think I may go for a genetic testing and see which kind it is.

[JohnHaganMD]

I do not believe there is a test for that.

[JohnHaganMD]

Your cell count is not low if it is 2070.     Fuchs doesn't usually decompensated until 800 or less. This is some general information. THIS IS EXTREMELY IMPORTANT. Corneal transplants are not done for Fuch's in advanced treatment. If the cornea goes bad a procedure call DSEAK  is done where the inner layer of the cornea is removed and donor tissue replaced. Much much safer and faster healing. GENERAL INFO FROM PREVIOUS POST;
There is no exact definition of how many guttatta it takes to diagnosis Fuchs' Endothelial Corneal Dystrophy. Some guttatta are part of aging and do not ever become a problem. Two tests that are often helpful are corneal endothelial cell counts (the number decreases as the disease develops and progresses) and corneal pachymetry (corneal thickness) the thickness increasing as the disease develops and progresses. Family history is useful as many cases of Fuchs' are hereditary (affecting females more than males). Guttata are 'bumps' that develop on the back of the cornea when there are not enough endothelial cells to cover it. These cells are very important as they pump fluid out of the cornea and into the anterior chamber of the eye. The cornea is hydrophilic (water loving) like a sponge. When it swells and gets thicker it starts to become cloudy and blur the vision. When this happens and the impairment is severed than a corneal transplant is indicated. Recently a new operation for decompensated Fuchs' dystrophy called DSEAK (Descemet's membrane epithelial automated keratoplasty) has dramatically speeded the healing, safety and results over full thickness penetrating keratoplasty. Corneal endothelial cells do not multiply or replace themselves when damaged or cell death occurs.