Which tests are used to evaluate Fuchs Endothelial Dystrophy?

• A. NaFl (+/- bullae), Specular microscopy, Pachymetry, IOP
• B. MRI, CT
• C. Visual field testing
• D. Fluorescein angiography

Answer: (A)

Evaluating Fuchs endothelial dystrophy focuses on the health of the corneal endothelium and the presence of edema. The best approach uses tests that directly assess those aspects: specular microscopy to measure endothelial cell density and morphology (looking for guttata and cell loss), pachymetry to quantify central corneal thickness (edema makes the cornea thicker), and fluorescein staining to reveal epithelial bullae that form as the edema worsens. Intraocular pressure is also routinely checked as part of a comprehensive eye exam because it helps inform overall ocular health and guides planning if surgical treatment is considered.

Tests that image the brain or retina (MRI/CT, fluorescein angiography) or that assess optic or peripheral vision (visual field testing) don’t specifically evaluate the corneal endothelium or edema, so they aren’t used to evaluate Fuchs endothelial dystrophy.