Map-Dot-Fingerprinting and Fuchs Disease

I am 42 year old female diagnosed with Map-Dot-Fingerprint and Fuchs Disease in my right eye in Nov. 2009.  It all began with difficulty of opening my eyes after sleeping and progressed to blurred vision and a feeling of something foreign in my eye which was followed by severe pain.  I then had an opthamologist scrape to remove eroded areas of the cornea. This helped for about three months and then I found myself having the same problems again.  It was decided at that point that I have anterior corneal punctures to allow better adherence of cells. This was done in May of 2010.  I have been doing great until recently.  I am now experiencing some mornings in which it is difficult to open my right eye. But the problem doesn't stop there.  I am having the same problem in my left eye but more frequent - everytime I awake in the morning or if I take a nap I have difficulty opening my eye.  I believe now the epithelium is beginning to erode in this eye because I am having sever blurred vision as well as a feeling of something in my eye.  My question is what are the treatments that are available to me considering I not only have Map-Dot-Fingerprint but also Fuchs Disease?

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

That association is not unusual. It doesn't make the treatment of recurrent corneal erosions more difficult. Use the search feature and archives and check Dr.hagan's blog for more information.

Usually it involves using Muro 128 ointment every night in both eyes and Muro 128 drops on awakening and several times per day.

JCH MD

[susception]

Unfortunately my eyes are not responding to this treatment of Muro 128 ointment and drops.  This morning was the worst yet. My eyelids would not open...after a couple of minutes I blindly made my way to the restroom to grab a warm wash cloth to put over my eyes which aides in helping the eyelids open.  I do have an appointment tomorrow so will hopefully find a longer lasting solution to this problem.  I was hoping to have more insight on other procedures that may have helped others with my problem.  More than likely they will put a bandage contact over my eye but this just sounds like a temporary solution...the problem seems to be reoccurring with no end in sight. Does a cornea transplant appear to be in my future?

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

I do not think you read my blog. Go to it and read it. Other options explained there are eximer laser resurfacing of the cornea or a several month trial of oral Tetracycline and topical steroid drops in a new treatment that has an effect on metalloprotease enzymes.

It is important to determine if your problem is mostly dot-map dystrophy (likely) or Fuch's (unlikely). By the way corneal transplants are not the treatment of choice for fuchs that have decompensated anymore a much safer and less expensive and faster healing operation called DSAEK is now done.

JCH MD

[sally987]

Dr. Hagan, I am wondering if dot-map is considered a heriditary conditon.  My mom has this, and I am wondering if there is anything that I can do preventively to make sure that my eyes stay healthy. Thanks so much~

[susception]

In my case, since I have both - map dot fingerprint and fuchs, I have been told that my condition is rare and treatments that would normally work for Fuchs, such as DSAEK, may not be a good option for me.  I am currently wearing contact bandages over both eyes.  I have been told that a cornea transplant will be likely later in life.  Would you recommend me to have a reevaluation?  Has there not been a lot of research done for patients that have Map Dot Fingerprint and Fuchs disease? I would appreciate any direction you could provide.  

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

Map-dot-fingerprint (basement membrane disease) is common. There are no studies that indicate its hereditary.

No there is not a lot of research on the two problems together because its hard to find large numbers of people with both problems.

Consider getting a second opinion from a corneal specialist. Find one near you at www.aao.org   I don't think that MBD would preclude DESAEK and its much safer.

JCH MD