The CMGs offer information on the diagnosis and management of a range of conditions that present with varying frequency in primary and first contact care.
Fuchs endothelial corneal dystrophy (FECD) is a progressive disease of the corneal endothelium. It is non-inflammatory, bilateral and usually inherited. The condition is more common in women than men. Patients are typically over the age of 50 at the onset of symptoms which include glare and blurred vision particularly on waking, but pain and photophobia may occur in advanced stages of disease. This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing and treating FECD. It outlines options for non-pharmacological management and pharmacological treatment, and highlights the need for possible referral for surgery where symptoms persist.
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What is corneal dystrophy?
A corneal dystrophy is a condition in which the cornea (the clear window of the eye) loses its normal transparency. It is usually inherited, affects both eyes and is progressive. There is no inflammation or infection. This particular corneal dystrophy was first described by an Austrian ophthalmologist, Ernst Fuchs, in 1910, and it has borne his name ever since. In this condition the cells lining the back of the cornea (the endothelial cells), which normally pump water out of the cornea, keeping it clear, no longer work properly. As a result the cornea becomes water-logged and cloudy and the vision becomes hazy. The condition is painless at first, but if, at a later stage, blisters form on the surface of the cornea and then burst, sharp pain may result.
How is corneal dystrophy managed?
No treatment is available to reverse this condition though lubricant eyedrops may help to make the eye more comfortable. If the vision is greatly affected or the eye is painful, the ophthalmologist may recommend a corneal transplant procedure. This has a good chance of improving the vision and making the eye comfortable.
Fuchs Endothelial Corneal Dystrophy - 4 June 2025 The aetiology section has been updated to include prevalence data for Fuchs' endothelial corneal dystrophy (FECD). The predisposing factors section has been revised to provide information on groups that are more likely to develop this condition. The symptoms and signs sections have been updated to include additional features which may be present at different stages of disease. The management sections now highlight the importance of documenting a diagnosis of FECD when referring for cataract surgery.
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