Sir,

With great interest I have read the comment of Professor Claoué on the use of the possessive ‘s’ or merely its apostrophe in ‘Fuchs endothelial dystrophy’.1 As a non-native English speaker, I have been told on many occasions that it might be better ‘to keep my mouth shut and appear stupid than to open it and remove all doubt’. However, risking eternal shame now seems outweighed by the urge to attempt to counter the issue.

On the continent, one teaches that a named disease loses the ‘s’ (or the apostrophe for a name ending with ‘s’) once it is generally considered to be an entity. The possessive ‘s’ would seem incorrect as the disorder was recognized, but not ‘owned’, by that person. In other words, for example in Fuchs endothelial dystrophy, one is not referring to the eyes of Dr Fuchs himself as being ill, but to a general disorder that bears his name. Similarly, we refer to entities like Bowman layer, Khodadoust line, Lyme disease, the London Tower, and so on.

The situation becomes even more complicated in discussions with some journals that voluntarily added an ‘s’ to the title in our papers on, for example, ‘Descemet’s stripping endothelial keratoplasty’. The ‘s’ may add to the confusion because, while referring to the general concept of a surgical technique, it is suggested that either Dr Descemet had to undergo the procedure himself or, even more doubtful, Dr Descemet has arisen from the grave to do the surgery himself or at least to strip during the procedure.

However, that being said, in the end all grammar may be overruled by native English speakers, who probably ‘feel’ what is most appropriate. The apostrophe poses a devil’s dilemma, whereas ‘devil dilemma’ would appear more accurate.