Causes. Doctors are not sure what causes Fuchs’ dystrophy. Women seem to be more at risk of the disorder than men. Smoking and having diabetes also increase the risk of developing Fuchs’ dystrophy. Some medical researchers believe that the disease is genetic, but the pattern of inheritance is not straightforward. In some patients, there seems to be no history of the disorder in their family. However, researchers have found several genes that might play a part in Fuchs’ dystrophy, including the COL8A2 gene. This gene may be partially responsible for an early-onset form of the disease. The gene helps the body make a protein that makes up type VIII collagen, which is found in Descemet’s membrane. This structure is found in the cornea and supports the endothelial cells. A mutation in the COL8A2 gene might cause the Descemet’s membrane to be abnormal.