A century ago, the Austrian ophthalmologist Ernst Fuchs initially identified the degenerative, genetic illness of the cornea known as Fuchs' corneal dystrophy (FCD). Patients frequently first exhibit foggy morning vision in their fifth to sixth decade of life, which lasts longer as the condition worsens. The syndrome, which mostly affects the posterior cornea, is characterised by the development of so-called "guttae," or localised excrescences of Descemet membrane, loss of endothelial cell density, and end-stage illness, which includes corneal edoema and the growth of epithelial bullae. There are now fresh chances for improved outcomes for FCD patients thanks to recent developments in our knowledge of the genetic and pathophysiological pathways underlying the condition as well as the use of novel imaging modalities and less invasive surgical techniques. Patients and professionals who want to stop the start or progression of disease would greatly benefit from knowing the risk factors linked to FCD. It is yet unclear how UV radiation contributes to the development or worsening of FCD. Guttae in FCD frequently have an inter-palpebral distribution, which raises the possibility that environmental exposure is involved. Additionally, the closer closeness to the equator may have a factor in Singapore's greater illness prevalence than Japan's. Nevertheless, the Reykjavik Eye Study participants' solar UV exposure evaluation revealed no appreciably greater risk from increasing UV exposure throughout the third, fourth, or fifth decades of life. The severe epithelial form of FCD, first described by Fuchs, progresses along a course that typically starts in early middle age, frequently in women, and lasts for two to three decades. The clinical development of the disease spans a course from early endothelial changes when patients are asymptomatic to this stage. When symptoms first appear, they might include a painless loss of visual acuity, photophobia, glare, and light haloes that are worst in the morning. Patients with advanced FCD should be informed about both PK and DSEK (Descemet stripping endothelial keratoplasty) as treatment options in the clinical environment, with the option of being referred, if necessary, to a surgeon who can carry out the less invasive surgery. Patients with clinically severe FCD and cataracts may undergo the triple treatment, with DSEK now being used in a novel variation of this technique.