Fuchs syndrome

Dystrophic processes in the iris and ciliary body develop rarely. One of such diseases is Fuchs dystrophy, or heterochromic Fuchs syndrome. It usually occurs in one eye and includes three mandatory symptoms - protein precipitates on the cornea, a change in the color of the iris, and clouding of the lens. As the process develops, other symptoms join - anisocoria (different width of the pupils) and secondary glaucoma. Friends and relatives of the patient are the first to discover signs of the disease: they notice the difference in the color of the iris of the right and left eyes, then pay attention to the different width of the pupils. The patient himself, aged 20-40, complains of decreased visual acuity when clouding of the lens occurs.

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Symptoms of Fuchs syndrome

All symptoms of Fuchs syndrome are caused by progressive atrophy of the iris stroma and ciliary body. The thinned outer layer of the iris becomes lighter, and the lacunae are wider than in the fellow eye. The pigment sheet of the iris begins to shine through them. By this stage of the disease, the affected eye is already darker than the healthy one. The dystrophic process in the ciliary body processes leads to changes in the capillary walls and the quality of the fluid produced. Protein appears in the moisture of the anterior chamber, settling in small flakes on the back surface of the cornea. Precipitate rashes may disappear for a period of time, and then reappear. Despite the long-term, several-year existence of the precipitation symptom, posterior synechiae do not form in Fuchs syndrome. Changes in the composition of the intraocular fluid lead to clouding of the lens. Secondary glaucoma develops.

Previously, Fuchs syndrome was considered an inflammation of the iris and ciliary body due to the presence of precipitates - one of the main symptoms of cyclitis. However, in the described clinical picture of the disease, four of the five general clinical signs of inflammation known since the time of Celsus and Galen are absent: hyperemia, edema, pain, increased body temperature, only the fifth symptom is present - dysfunction.

Currently, Fuchs syndrome is considered a neurovegetative pathology caused by a violation of innervation at the level of the spinal cord and cervical sympathetic nerve, which manifests itself as dysfunction of the ciliary body and iris.

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Treatment of Fuchs syndrome

Treatment of Fuchs syndrome is aimed at improving trophic processes; it is ineffective. When opacities in the lens lead to a decrease in visual acuity, complicated cataracts are removed. Surgical treatment is also indicated in the development of secondary glaucoma.

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