Dry eyes and guttata

I was diagnosed with guttata a year and a half ago but a corneal specialist told me I probably would not have a problem until I was 100 ! I am 74 .A year ago I had cataract surgery in both eyes and since then have developed very dry eyes. My vision which was great after the surgery has deteriorated over the last few months. Is there any connection between the dry eyes and the guttata ? I am using eye drops during the day and a thicker ointment at night. In the morning my eyes are blurry for about half an hour even when I don't use the ointment at night. The tech who did the third refraction in a month thinks the problem with the eyes is the dryness as each refraction has given different results the last being 20/40. I see the ophthalmologist in to weeks but wonder if you have any advice. Thanks.

[Michael J Kutryb, MD]

It is most likey due to dry eyes which is unrelated to the guttata.  I would look at the condition of the tear film and corneal surface (for dry eye problems) and the corneal stroma and endothelium (for guttata and fuch's corneal dystrophy problems.)  I would also look at the corneal thickness (pachymetry) and the corneal endothelial biomicroscopy with a Konan endothelial cell counter to see the number and condtion of the endothelial cells.  It is not uncommon to have both dry eyes and fuch's corneal dystrophy.  Since not much can be done for Fuch's dystrophy, I would concentrate on the dry eye treatment to the maximum degree in hopes  to improve some of your symptoms.

MJK MD