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Fuchs Corneal Dystrophy
June 24, 2023

Harnessing the Power of Scleral Lenses: A Revolution in Fuchs Corneal Dystrophy Treatment


This comprehensive article presents an in-depth discussion about Fuchs Corneal Dystrophy (FCD) and the potential benefits of Scleral Lenses for individuals suffering from this eye condition. The article begins by explaining what FCD is and how it affects individuals, followed by an overview of traditional treatments.

The focus then shifts to Scleral Lenses, explaining their design, functionality, and specific benefits for FCD patients. Dr. Edward Boshnick’s role as a champion of Scleral Lenses for FCD treatment is detailed, with real-life success stories from his patients providing further testament to their effectiveness. The article concludes by contemplating the future of FCD treatment, emphasizing the potential role of Scleral Lenses.


  • Fuchs Corneal Dystrophy is a serious eye condition that affects vision, and traditional treatments often have limitations.
  • Scleral Lenses can be a highly effective solution for FCD, offering comfort, vision clarity, and eye protection.
  • Dr. Edward Boshnick’s work in this field has contributed significantly to the advancement of Scleral Lenses as a treatment for FCD.
  • Personal testimonials highlight the transformative impact of Scleral Lenses on patients’ lives and vision.
  • The future of FCD treatment is promising, with Scleral Lenses leading the way as a preferred method of management.


Vision is a precious sense that allows us to explore the world around us, witness the faces of our loved ones, and live independently. But, what happens when this gift is compromised by a disorder as devastating as Fuchs Corneal Dystrophy (FCD)?

FCD is a slow, progressive disorder affecting the cornea, the clear front surface of the eye, which could lead to vision loss or blindness if untreated. This can undoubtedly be a daunting prospect for anyone diagnosed with this condition. The traditional line of treatment, which includes medicated eye drops and invasive procedures like corneal transplantation, does offer hope but often comes with its limitations and complications.

However, all is not bleak. With recent advancements in the field of ophthalmology, a novel, non-invasive treatment alternative known as Scleral Lenses has emerged. They promise a future where managing FCD could become less cumbersome and more effective.

This comprehensive guide will dive into FCD, exploring its causes, symptoms, and the impact it can have on one’s vision. We will discuss traditional treatment methodologies, their pros and cons, and then introduce the groundbreaking concept of Scleral Lenses. We will unravel how Scleral Lenses work, their potential benefits, especially for those dealing with FCD, and why they are gaining popularity among eye-care professionals and patients alike.

We will also take you through the journey of Dr. Edward Boshnick, a pioneer in the application of Scleral Lenses for FCD treatment, and share the inspiring success stories of patients who have benefitted from this innovative approach.

Join us as we delve into the world of FCD and how Scleral Lenses are revolutionizing its treatment landscape.

Understanding Fuchs Corneal Dystrophy

Fuchs Corneal Dystrophy










Fuchs Corneal Dystrophy (FCD) is a degenerative eye condition that affects the endothelial cells lining the innermost layer of the cornea, known as the endothelium. The cornea, the clear front window of the eye, relies on these cells to pump out excess fluid and keep it transparent. If these cells dwindle or function inadequately, as is the case with FCD, fluid buildup can cause the cornea to swell, leading to blurry or hazy vision.

FCD, named after the Austrian ophthalmologist Ernst Fuchs who first described it in 1910, predominantly occurs in adults over the age of 50, but early symptoms might appear in one’s 30s or 40s. It is more common in women than men and often shows a genetic predisposition. According to the National Eye Institute (NEI), some individuals are at a higher risk due to the FCD gene mutation in their families (source).

Symptoms of FCD can progress gradually, starting with morning vision problems that tend to improve as the day progresses. This occurs because the cornea accumulates fluid during sleep, which gets gradually pumped out when the eyes are open. As FCD advances, visual disturbances may last throughout the day and include blurry vision, sensitivity to light and glare, painful blisters on the cornea, and severely impaired vision.

In FCD, the corneal endothelial cells exhibit an abnormal propensity to secrete collagen deposits, creating a distinctive pattern known as guttae. These tiny bumps on the endothelial surface can be detected via a slit-lamp examination. As FCD progresses, the guttae coalesce, causing more pronounced visual disruptions. Diagnostic tests like Specular Microscopy can further help visualize these cellular changes in detail (source).

The progression of FCD can vary significantly among individuals, with some experiencing a mild form of the disease that doesn’t affect their daily lives, while others may suffer severe vision loss. However, early detection and appropriate management can help control the symptoms and prevent further deterioration.

Traditional treatment for FCD aims to manage the corneal swelling and improve visual comfort. This often involves the use of hypertonic saline eye drops or ointments that draw out the excess fluid from the cornea. However, these treatments only provide temporary relief and do not halt the progression of the disease. For advanced cases of FCD, corneal transplantation is usually recommended, which comes with its own set of potential complications.

It’s in this context that scleral lenses offer a promising alternative. These specially designed contact lenses have the potential to improve visual acuity and comfort, providing a promising line of management for FCD patients.

In the next section, we will take a closer look at the traditional treatment options for FCD, their benefits, and limitations.

Traditional Treatment Methods for Fuchs Corneal Dystrophy

Traditional treatment methods for Fuchs Corneal Dystrophy (FCD) are largely focused on managing the symptoms, particularly corneal swelling (edema), which is the root cause of vision impairment in this condition. The first line of defense typically includes hypertonic saline solutions applied as eye drops or ointments. These hypertonic solutions work by drawing fluid out of the swollen cornea, thereby temporarily alleviating symptoms like hazy vision and discomfort.

While these treatments can provide some relief, their effects are temporary and do not stop the disease’s progression. They are mostly used to manage the condition in its early stages or as a supplementary treatment following surgical intervention.

When the disease progresses to a stage where non-invasive treatments can no longer effectively manage the symptoms, surgical intervention becomes necessary. The most common form of surgery for FCD is a corneal transplant, which can take two forms: a full-thickness corneal transplant (Penetrating Keratoplasty, or PK) or a partial-thickness corneal transplant (Endothelial Keratoplasty, or EK).

In Penetrating Keratoplasty, the surgeon removes the entire cornea and replaces it with a healthy donor cornea. This procedure has a long track record of success but also carries potential complications such as rejection of the transplanted cornea, astigmatism, and infection.

Endothelial Keratoplasty, on the other hand, involves replacing only the diseased endothelial layer of the cornea. This method is less invasive than PK, and patients typically experience faster recovery times and fewer complications. Descemet Stripping Endothelial Keratoplasty (DSEK) and Descemet Membrane Endothelial Keratoplasty (DMEK) are two types of EK procedures.

Both PK and EK require the use of donor corneas, which can sometimes be a limiting factor due to availability. Moreover, like all surgical procedures, they carry risks and potential complications. A significant percentage of corneal transplant patients also require corrective eyewear post-surgery for optimal vision.

This is where the potential of scleral lenses comes into play. These specially designed lenses sit on the sclera (the white part of the eye), creating a tear-filled vault over the cornea. This unique design helps to improve vision and comfort for individuals with corneal irregularities like FCD, without the need for invasive surgery.

In the next section, we will delve deeper into the world of scleral lenses, their design, functionality, and benefits for individuals suffering from Fuchs Corneal Dystrophy. The American Academy of Ophthalmology provides an excellent overview of FCD treatment options, including scleral lenses, which we recommend checking out for more information (source).

As always, it is essential to consult with an experienced eye care professional to evaluate your specific condition and determine the best course of treatment.

Introduction to Scleral Lenses

Scleral lenses are a type of contact lens that rest on the white part of the eye known as the sclera. They differ significantly from standard soft and hard (RGP) contact lenses due to their larger diameter, which typically ranges from 14 mm to over 20 mm. The National Keratoconus Foundation provides detailed insights on the use of scleral lenses for different corneal disorders.

Designed to vault over the entire corneal surface, scleral lenses create a smooth optical surface, thereby correcting vision problems caused by corneal irregularities such as keratoconus, post-corneal transplant, and conditions like Fuchs Corneal Dystrophy. The space between the back of the lens and the cornea is filled with a saline solution, which keeps the cornea hydrated and helps soothe symptoms of dry eye.

The advent of modern technology, computer-aided design, and manufacturing have led to significant improvements in scleral lens design and customization. Today’s scleral lenses are highly customizable and can be made to precisely match the individual’s eye shape, ensuring better fit, comfort, and vision correction. In fact, some specialized eye clinics use technologies like optical coherence tomography (OCT) and computerized corneal topography to measure the eye’s shape and customize the scleral lens design accordingly.

However, the use of scleral lenses is not without challenges. Due to their larger size, they can be more difficult to insert and remove compared to standard contact lenses. Some patients may also experience initial discomfort or require an adaptation period to get used to the lenses. Proper hygiene and regular follow-ups with the eye care professional are also essential to avoid potential complications such as lens deposit build-up or infections.

Nevertheless, for many patients with corneal disorders like Fuchs Corneal Dystrophy, the benefits of scleral lenses far outweigh these challenges. In the following section, we will take a detailed look at why scleral lenses can be a game-changer for FCD patients, providing them with improved vision and quality of life.

For further reading on the design and functionality of scleral lenses, the Scleral Lens Education Society provides patient-friendly guides about their use and care. As always, it’s crucial to consult an eye care professional experienced in fitting scleral lenses to determine if they are a suitable option for you.

The Advantages of Scleral Lenses for Fuchs Corneal Dystrophy Patients

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This patient suffers from a specific type of corneal dystrophy which made both of her eyes extremely dry and painful. We fit both of this patient’s eyes with scleral lenses which are allowing her to see clearly and comfortably once again.

Scleral lenses can offer several advantages over traditional treatment methods for patients with Fuchs Corneal Dystrophy (FCD). One of the primary benefits is their ability to provide clear, sharp vision, even for individuals with severe corneal irregularities.

  1. Vision Clarity: The large diameter and unique design of scleral lenses allow them to vault over the irregular cornea and rest on the sclera. This design helps to neutralize the distortions caused by Fuchs Corneal Dystrophy and provide a smooth refractive surface, leading to significantly improved vision clarity.

  2. Comfort: Scleral lenses do not directly contact the cornea, reducing the discomfort associated with other types of contact lenses. Additionally, the liquid reservoir between the lens and the cornea can provide relief from the dryness and gritty sensation often experienced by FCD patients.

  3. Protection: By vaulting over the cornea, scleral lenses create a physical barrier between the outside environment and the cornea. This shield can protect the delicate corneal surface from exposure to dust, wind, and other potential irritants.

  4. Stability: Given their large size, scleral lenses are less likely to dislodge from the eye during physical activities compared to regular contact lenses. This stability can be particularly beneficial for active individuals or those engaged in sports.

  5. Versatility: Scleral lenses can correct a wide range of refractive errors, including myopia (nearsightedness), hyperopia (farsightedness), astigmatism, and presbyopia (age-related farsightedness).

These benefits make scleral lenses a valuable tool in managing FCD symptoms and improving patients’ quality of life. However, successful scleral lens wear depends on an accurate fit. This is why it’s essential to consult with a professional like Dr. Edward Boshnick who has extensive experience in fitting these specialized lenses.

As the Contact Lens Spectrum notes, the application of scleral lenses has expanded dramatically over the past decade, benefitting patients with a wide range of corneal conditions. But it’s essential to remember that while scleral lenses can manage FCD symptoms, they don’t cure the condition itself. Regular check-ups with an eye care professional remain vital to monitor the disease’s progression and adjust treatment plans as needed.

In the next section, we’ll discuss the role of Dr. Edward Boshnick in the scleral lenses treatment for Fuchs Corneal Dystrophy.

Dr. Edward Boshnick and His Role in Scleral Lenses Treatment

Dr. Edward Boshnick has been at the forefront of scleral lens technology for years. His work in this field has made a significant impact on patients suffering from a variety of corneal disorders, including Fuchs Corneal Dystrophy.

Dr. Boshnick operates at the Global Vision Rehabilitation Center in Miami, Florida, where he specializes in fitting scleral lenses for patients with corneal irregularities. He is a firm believer in the power of scleral lenses in improving the quality of life of his patients.

As a member of the Scleral Lens Education Society, Dr. Boshnick is committed to furthering his knowledge and experience in the field. He has successfully treated hundreds of patients with Fuchs Corneal Dystrophy, using scleral lenses to help them achieve improved vision and comfort.

Dr. Boshnick’s patient-centric approach ensures each patient’s needs are met with customized treatment plans. His thorough examinations include the use of advanced diagnostic tools, like Cirrus Optical Coherence Tomographer, to assess the severity of the patient’s condition and devise the best course of treatment.

Not only does he have the technical skills and knowledge required to fit scleral lenses, but Dr. Boshnick also provides extensive patient education. He believes in empowering his patients with information about their condition and how scleral lenses can help manage their symptoms.

His expertise, compassion, and dedication have earned him a reputation as a trusted eye care provider. His patients often commend his willingness to explore all possible treatment options and his dedication to achieving the best possible outcome for each individual.

Dr. Boshnick’s role in advancing the use of scleral lenses for treating Fuchs Corneal Dystrophy is substantial. His experience and commitment to providing the highest quality eye care make him an asset to patients suffering from this debilitating condition. But don’t just take our word for it; read on to hear from patients who have directly benefited from his expertise.

Conclusion: The Future of Fuchs Corneal Dystrophy Treatment

As we continue to understand more about Fuchs Corneal Dystrophy, the treatment options for this condition will continue to evolve. Currently, scleral lenses represent a safe, effective, and non-invasive alternative to traditional treatments.

The future of Fuchs Corneal Dystrophy treatment is promising. With advancements in technology, we can expect even more personalized and effective treatment methods. Moreover, as the use of scleral lenses continues to grow, so does our understanding of their potential benefits for patients with Fuchs Corneal Dystrophy and other corneal conditions.

Dr. Boshnick and other eye care professionals dedicated to advancing scleral lens technology are leading the charge in bringing this effective treatment to more patients. If you’re suffering from Fuchs Corneal Dystrophy, consider consulting with a qualified professional like Dr. Boshnick to see if scleral lenses could be a good option for you.

In the meantime, continue educating yourself about your condition and potential treatments. As Dr. Boshnick often tells his patients, being an informed patient is the first step towards better eye health.

That concludes our discussion on Fuchs Corneal Dystrophy and the potential benefits of scleral lenses as a treatment option. We hope this information has been helpful and encouraging to those living with this condition and their loved ones. For more information about Fuchs Corneal Dystrophy and other eye health topics, continue exploring our website.

Frequently Asked Questions (FAQs)

1. What is Fuchs Corneal Dystrophy?

Fuchs Corneal Dystrophy is a progressive eye disorder that affects the cornea, the clear front surface of the eye. It causes the cells in the corneal endothelium to deteriorate, leading to vision problems. You can read more about this condition here or visit the National Eye Institute’s page for additional information.

2. What are scleral lenses?

Scleral lenses are a type of contact lens that covers the entire corneal surface and rests on the white part of the eye (sclera). They create a fluid-filled layer over the cornea, which can help improve vision in conditions like Fuchs Corneal Dystrophy. Learn more about scleral lenses here or check out the Scleral Lens Education Society’s patient handouts.

3. How do scleral lenses help in managing Fuchs Corneal Dystrophy?

Scleral lenses can significantly improve visual acuity and comfort in patients with Fuchs Corneal Dystrophy. They help maintain a constant reservoir of fluid between the lens and the cornea, which can compensate for the irregular corneal surface. You can read more about this in our article about corneal refractive therapy with Paragon CRT.

4. How are scleral lenses different from regular contact lenses?

Unlike regular contact lenses that fit on the cornea, scleral lenses cover the entire corneal surface and rest on the sclera. This makes them ideal for conditions like Fuchs Corneal Dystrophy, where the cornea is irregular. More details can be found here.

5. Who is Dr. Edward Boshnick?

Dr. Edward Boshnick is a globally recognized expert in the field of specialty contact lens fitting, including scleral lenses. He has extensive experience treating patients with a variety of corneal disorders, including Fuchs Corneal Dystrophy. You can read more about Dr. Boshnick here.

6. How successful has the use of scleral lenses been in treating Fuchs Corneal Dystrophy?

Many patients with Fuchs Corneal Dystrophy have reported significant improvements in their vision and quality of life after being fitted with scleral lenses. Check out our success stories for real-world examples.

7. Can I use scleral lenses if I’ve undergone corneal transplantation?

It’s possible to use scleral lenses after a corneal transplant, depending on the specifics of your condition and recovery. However, you should always consult with an eye care professional before making this decision.

8. What is the future of Fuchs Corneal Dystrophy treatment?

As we understand more about Fuchs Corneal Dystrophy, the treatment options continue to evolve. Scleral lenses represent a promising non-invasive alternative to traditional treatments. Future advancements in technology may lead to even more personalized and effective treatment methods.

9. Where can I learn more about Fuchs Corneal Dystrophy and its treatment options?

You can find comprehensive information on our website’s corneal dystrophy and degeneration page. For a detailed overview of Fuchs’ Dystrophy, including its symptoms, causes, and treatment options, visit the National Eye Institute’s page.

10. How can I schedule a consultation with Dr. Boshnick?

You can schedule a consultation with Dr. Boshnick by visiting our contact page and filling out the form, or by calling our office directly. We look forward to assisting you with your eye care needs.


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