Patient: 58 years of age, female, BCVA 0.6 at OD, 0.7 at OS, pachymetry 589 µm/ 602 µm. Ocular Medical History: decrease of vision, not improvable by glasses. General Medical History: empty. Purpose: to show slitlamp- and specular microscopy- images of endothelial cells. Methods: Colour Photography Anterior Segment, non-contact Specular Microscopy Konan Medical. Findings: Colour Photography Anterior Segment: thickening of Descemet’s membrane, microscopic collagenous excrescences (guttae). Non-contact Specular Microscopy Konan Medical: pleomorphism, polymegathism with increased variation in the sizes of the endothelial cells , guttae appearing as dark areas, cell loss, morphing of surrounding cells to fill in the compromised endothelium. Discussion: Fuchs’ endothelial dystrophy (FED) is a familial, and slowly progressive disorder affecting the corneal endothelial cell monolayer. In the United States, FED affects about 4 % of the population over the age of forty. Li et al. (1) performed a meta-analysis suggesting that there is a genetic association between four TCF4 polymorphisms (rs613872, rs2286812, rs17595731, and rs9954153) and the risk of fuchs' endothelial dystrophy. Literature: (1) Li D, Peng X, Sun H. Association of TCF4 polymorphisms and fuchs' endothelial dystrophy: a meta-analysis. BMC Ophthalmol. 2015 Jun 19;15(1):61.