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Detection and Diagnosis

Detection and Diagnosis

If you notice the general symptoms of Fuchs Dystrophy, a visit to your doctor's office is recommended.  At the office, your ophthalmologist will typically investigate these symptoms through three different methods: slit lamp microscopy, pachymetry and confocal microscopy.

slit-lamp microscopeSlit Lamp Microscopy

This instrument is found in the every ophthalmologist and optometrist’s office.  Its name comes from the fact that its beam of light can be adjusted from a thin slit to a round circle, depending on what part of the eye the doctor wants to see.

A doctor examining a patient using a slit-lamp
A doctor examining a patient using
a slit-lamp microscope.

When the doctor looks at the eye using a slit-lamp microscope, this is what he sees:

thin beam of light shining on the eyebeam of light on eye close up

Full view of the eye.  Note the thin beam of light shining on the eye (arrow).  This patient does not have Fuchs Endothelial Corneal Dystrophy (FECD).

This is the same sort of view as the one to the left, but the photo has been taken closer up.  This patient has advanced FECD.

  
view of lensside-view of cornea

View of the lens (this one is clear—no cataract) and the cornea.  An arrow is pointing to the cornea.    The greenish football shaped thing is the lens. 

Side view of the cornea.  This patient has FECD.

  
retroillumination image of health corneaRetroillumination image, cornea with advanced FECD

A retroillumination image of a healthy cornea.  This view is always reddish because the light goes straight in and then bounces off the retina (which has lots of blood vessels in it). 

Another retroillumination image of the cornea.  This patient has advanced FECD.

  

Pachymetry

An instrument called a pachymeter measures corneal thickness.  This instrument is useful in resolving disorders that cause the cornea to thicken, such as Fuchs Dystrophy.

measuring a patient’s corneal thickness

Please note: 

This patient does NOT have Fuchs Dystrophy. 

In addition, we altered the corneal thickness reading upward (to 657 microns).

A doctor measuring a patient’s corneal thickness using a pachymeter.

Confocal Microscopy

The Confocal Spectrometer Microscope.A confocal microscope uses a flashing light to take lots of pictures very quickly, one right after the other.  This instrument is used to study the corneal endothelium.  It measures the number, density, and shape of the endothelial cells.  It magnifies them thousands of times.  Pleomorphism (variations in shape), and guttae (dewdrop-like shapes that are signs of Fuchs) are easy to see thanks to the photographs that the confocal microscope produces.

  

The pictures below were taken with a confocal microscope:

The beginnings of FECDModerate FECD (late-onset type).Advanced FECD (early-onset type).

The beginnings of FECD (late-onset type).

Moderate FECD (late-onset type).

Advanced FECD (early-onset type).

To learn more about the different types (early- vs. late-onset) of FECD, follow the link to go to the section of this site entitled, Types of Fuchs Dystrophy.

 

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