Blurry vision - cornea problem

[EverythingIsBlurry]

As background, I have myopia, astigmatism, and presbyopia. The last time I got glasses it appeared that they did not correct my vision. I went to another optometrist and got new glasses but the same thing happened. Then I realized that the problem is my eyes, not the glasses. The optometrist retested me and said I have map dot dystrophy. Then I went to an ophthalmologist (cornea specialty) who so far has tried two conservative treatments: 1) Elestat drops to control eye allergy, and 2) Lotemax drops to try to calm down my changing vision. Neither have worked although the Elestat did appear to fix mucus buildup in my eye.

The ophthalmologist is talking now about doing surgery. He wants me to have cataract surgery, which I believe is just because he sees early stage signs and wants to take care of this while we are doing things to my eyes. More importantly he wants to perform PTK or PTK/PRK to smooth the cornea, eliminate the blurriness, and while we're at it, do refractive correction.

However so far I don't even know what the diagnosis is. I see lots of articles about various dystrophies, but I don't know which one I might have and if this treatment should work. He told me that I do have map dot dystrophy but that this is not causing my problem - it is genetic and I've had it all along.

I am scheduling a second opinion, hopefully from a well-regarded cornea specialist.

Do you have any other suggestions or am I following all the right steps. Thanks for your input.

[Sandra M Brown, MD]

Something is not adding up.  Map-dot-fingerprint dystrophy is the old descriptive term for what is now called anterior basement membrane disease (or sometimes epithelial basement membrane disease).  It only interferes with vision if it is quite severe.  The most common problem is a condition called recurrent corneal erosion, and you can read a ton about that at www.dryeyezone.com.  RCE is extremely painful, you would know if you were having them.  Do not have cataract surgery if your cataracts are not reducing your vision.  Certainly, do not do all sorts of things at once - cataract surgery, laser refractive surgery, laser therapeutic surgery, etc.

Neither elestat nor lotemax treats MDF dystrophy.  You have some sort of ocular surface condition such as chronic allergies or dry eye syndrome which might explain the fact that glasses can't improve your vision.  Proceed cautiously.  Don't leave the office of the cornea specialist until you fully understand what is going on.

[EverythingIsBlurry]

Thank you for the very good advice. I will be assertive to get answers from the specialists before proceeding.