Hence, patients with a history of Fuchs dystrophy may be at a greater risk of corneal edema after ocular surgery as they have fewer functioning endothelial cells.FECD is classified into 4 stages, from early signs of guttae formation to end-stage subepithelial scarring. Diagnosis is made by biomicroscopic examination in the clinic. Other modalities, such as corneal thickness measurement (pachymetry), in-vivo confocal biomicroscopy, and specular microscopy can be used in conjunction.The exact pathogenesis is unknown but factors include endothelial cell apoptosis, sex hormones, inflammation, and aqueous humor flow and composition. Mutations in collagen VIII, a major component of Descemets membrane secreted by endothelial cells, have been linked to the early-onset FECD.As a genetically heterogeneous disease, the phenotype, or clinical experience of patients with Fuchs dystrophy may reflect the combination of genetic contributors to the disease. Some genetic lesions correlate with more severe disease and earlier onset. Therefore, some individuals may experience symptoms of the disease at a much earlier age, while others may not experience symptoms until late in life.Genes include:

Diagnosis
The diagnosis of Fuchs dystrophy is often made with slit lamp biomicroscopy. With direct illumination, the clinician can visualize guttae, the characteristic pathological changes in disease.Scheimpflug imaging, anterior segment optical coherence tomography, confocal microscopy, and specular microscopy are additional imaging techniques that can identify the presence of guttae and quantify the thickness of the cornea.
As only a subset of patients with endothelial changes proceeded to epithelial involvement, Graves stated on 19 October 1925 to the New York Academy of Medicine that "Fuchs epithelial dystrophy may be a very late sequel to severer cases of the deeper affection". See also
Fuchs heterochromic iridocyclitis (a disease of the iris)
Ocular straylight

References
External links
Facts About the Cornea and Corneal Disease - The National Eye Institute (United States)
Fuchs dystrophy at Curlie