About 2 months ago overnight I developed intermittent double vision
in both eyes. I went to 3 different eye doctors. The first said
cataracts and referred me to a cataract surgeon. The second said I
need new glasses which didn't help.
The cataract surgeon said Fuchs's Cornea Dystrophy.
The cataract surgeon measured cornea thickness 630 right, 645 left,
cornea pressure 17 R 15 L, Guttata grade 3 plus, cell count not
measured. I am getting the morning fuzzy vision. On a home eye
chart morning vision is 20/40 R 20/50 L. In the afternoon it is
20/20 L 20/25 R. I am using Muro eye drops and ointment at night.
It seems to clear the vision somewhat.
I am a 68 year old male. The cataract surgeon said I have some
cataracts, but with the Fuchs's he would not operate.
Is Fuchs's that difficult to diagnose?
How common of a condition is it?
How likely is the cataract surgeon to have the right diagnosis?
Do I need a fourth opinion?
Is the onset usually so sudden (overnight)?
Given my history and current state what is the likely progression of the disease?
Fuch's is fairly common in older patients. I see several patients every week. Just have the doctor show you a copy of the endothelial cell count - it will be completely obviousy to you and everyone if you have Fuch's - so the diagnosis is very easy to make. It sounds like that is what you have. For now your vision is good enough to avoid cataract surgery for some time. The Fuch's disease take 10-20-30 years to come one and get to a serious level. Your disease will get worse - and there's not really anything you can do to slow it down. If it gets bad enough - you will be able to have a corneal transplant procedure or DSAEK. The only real issue is whether your corneas will tolerate cataract surgery or if they will fail and cloud over due to the very low cell count. With your increased corneal thickness it sounds like you will may not do very well with cataract surgery. I would see a corneal specialist who is proficient at DSAEK surgery because that is what you might need someday in conjuction with your cataract surgery. Your problem is very common and can be dealt with in a very efficient and usually successful manner when the times comes for surgery.
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