Causes, impact, and reversibility of glare in patients with Fuchs endothelial corneal dystrophy: A review

Fuchs endothelial corneal dystrophy (FECD) is a degenerative, autosomal dominant disorder predominantly affecting the female population and can lead to progressive loss of vision. A primary and debilitating symptom of FECD is glare, which severely impairs visual acuity and quality of life. Glare in FECD is caused by light scatter due to structural changes in the cornea, particularly central guttae formation in the Descemet membrane. These changes result in forward and backward light scatter, leading to disability glare and reduced contrast sensitivity. These visual disturbances are particularly dangerous, contributing to a higher risk of road traffic accidents. Many intrinsic factors such as certain genetic mutations can lead to degeneration of the Descemet’s membrane. Extrinsic factors such as smoking, dietary and lifestyle factors, ultraviolet radiations, oestrogen quinones can also lead to corneal dystrophy. Addressing glare through surgical interventions, primarily Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK), has shown to improve visual clarity and reduce glare symptoms. Understanding and addressing glare in FECD is essential for improving patient outcomes. Continued research and advancements in treatment techniques are vital for enhancing the quality of life for individuals affected by this debilitating condition. This review focuses on highlighting the various aspects leading to FECD, the impact of glare on patients, and summarizes the surgical options for glare reversal in these patients.