possible to have fuchs dystrophy and dry eye?

[MarSharky]

I already know that I have fast developing posterior subcapsular cataracts in both eyes.  My eye docs for the past 15 years or so have all told me they never saw anyone with such dry eyes, but I never did anything about it.  Can't wear contacts, they pop right out of my eye as soon as I stop putting in drops to moisten them.  (Was able to wear the AccuView Oasis for a few years, but then wanted to rip them out of my head after only an hour, so quit wearing them)

I saw a mention of Fuchs Dystrophy in my medical record, but not sure of the context.  Is it possible to have extremely dry eye and Fuchys Dystrophy concurrently?

My eyes are very, very blurry when I first wake up, either from night time sleeping or even when opening my eyes after riding for an hour in the bright sun with my eyes closed due to glare, but the longer I am up with eyes open, the better my vision clears.  Its taking longer to improve these past couple of weeks, and it doesn't seem to be improving as much as it used to, which could be the cataracts.  My last eye doc finally convinced me of why I need to use drops for dry eye, and have discovered it does help with blurriness, or at least it used to.  This past week it doesn't seem to have helped at all, and my eyes feel like they are sticky to the underside of my lid, or a fine sandpaper under my lid every time I blink.  No amount of drops seems to be helping anymore.  I see halos everywhere, bright light or dark ambiance lighting, even my hands are halos now.  

I did read that if you have Fuchs Dystrophy, precautions must be taken for cataract surgery, as if I don't already have issues with my anemia for that!  (I have a couple of other posts about that)  

I am 47 years old and my eye exam notes also indicated that there was no guttae.

[MarSharky]

Forgot to mention that about the time my blurriness stopped improving as well when waking, I also started getting a very odd floater-it looks alot like chicken wire but covers almost my entire field of vision when it appears.  I do have ALOT of floaters these days, all shapes and sizes, sometimes just tiny black dots, but it feels like I just walked into a swarm of flies or lovebugs because there are so many, sometimes almost losing my balance.  Floaters are getting worse and almost constant whenever outside with my pups.

[John C Hagan III, MD, FACS, FAAO]

Fuchs Dystrophy and dry eye can occur together but they are two separate problems not related (other than both occur more often in women)   If you don't have guttata you don't have FD because that is the main feature of the disease.  Go to my home page and read the section on dry eyes.   You should consider seeing a cornea Eye MD specialist about your dry eyes. You likely need to use a lubricating gel at bedtime, be sure you don't have a fan or moving air in your bedroom. You may need to go on one of the drops for moderate/severe dry eyes: Restasis (best) or Xiidra (widely expensive and not as effective).  A brand new drop Cequa has been released which is stronger than either but it is very new and I have no experience with it yet and don't know the cost.   PSC cataracts don't make the surgery any more difficult.

[MrPresley]

My wife was diagnosed with Fuchs Dystrophy in her right (dominant) eye when she went several weeks ago to her cataract surgeon to have a pre-surgical evaluation.  The office said to use Muro 128 drops four times a day up until the surgery scheduled for a couple of weeks from now.   She also uses OCuSOFT Retaine MGD drops recommended by our optometrist as needed following a corneal abrasion issue last year, and has previously used a gel at night as well. The only complicating issue the cataract surgeon mentioned with respect to having Fuchs Dystrophy was that he would wait at least two months to perform cataract surgery on her left eye if she chooses to have it done as well.

[JohnHaganMD]

Not to belabor the point but no guttatta ......no Fuchs.

[MarSharky]

Not trying to be a smarty-pants, but I am an engineer, so my brain thinks this way....does the gutyatta spontansously appear?  Or maybe it is not diagnosed as Fuch's until the guttatta do appear?  No leadup to it?  This might be akin to pre-eclampsia, it's not eclampsia until you have the seizure?  Maybe there is a pre-Fuch's?

[John C Hagan III, MD, FACS, FAAO]

No guttata develop over time. In Fuchs in women in families that have inherited Fuchs (some cases are spontaneous mutation) with family history of patients having surgery for cornea failure the guttatta can develop very young age.  Many people as they get older than say 60 develop some guttatta as a normal aging change.  I suppose if there were a lot of them it might be called "pre-Fuchs" although that is not a term Eye MDs use.  It is subjective how many guttatta make Fuchs Dystrophy.

[MarSharky]

Thank you for your explanation, Dr. Hagan.  I appreciate reading your responses to many of these posts.

[John C Hagan III, MD, FACS, FAAO]

You are welcome