Fuchs endothelial dystrophy, also known as guttata cornea, is a common phenomenon that increases significantly with age. In many patients with guttata cornea, the cornea appears normal in other aspects and does not affect vision. A small number of patients develop corneal stromal and epithelial edema, which can cause significant visual impairment. Fuchs first described this clinical phenomenon in 1910 and later realized that it was related to primary corneal endothelial dystrophy, with changes in the corneal epithelium and stroma being secondary. There are three clinical types of primary corneal punctate opacities: the first type is a few scattered degeneration points behind the cornea, which are part of the normal senile changes of the endothelium; the second type is an increase in the number of degenerations, often accompanied by endothelial pigment spots, which merge into a sheet, simply called "endothelial dystrophy"; the third type is an increasing number of degenerations, accompanied by corneal edema, which constitutes Fuchs endothelial dystrophy. Secondary punctate corneal degeneration occurs after corneal inflammation and is characteristic of syphilitic stromal keratitis.