Map Dot Fingerprint Dystrophy

Hello, @corinneh, and welcome to Mayo Clinic Connect. I imagine that is uncomfortable always feeling like you have something in your eye and having blurry vision with your now-diagnosed map dot fingerprint dystrophy.

I'd like to bring into this conversation other members who may have some thoughts for you as you deal with this condition and seek answers on what can be done. Please meet @hodagwi @dgray1110 @IndianaScott @suscros68 @ryman.

While awaiting their comments, I'd like to suggest reading this Mayo Clinic Medical Edge article https://www.seattlepi.com/lifestyle/health/article/Medical-EdgeAsk-The-Mayo-Clinic-1252428.php where Keith Baratz, M.D., ophthalmologist, talks about this condition.

Have you had therapy for this condition to this point, @corinneh? If so, what treatment have you undergone?

The only advice given to me by a Mayo physician was to use lubricating eye drops.
I found the article helpful, thank you.
Again, would like to hear if anyone else who has had this diagnosis and, now that I know there is a corrective procedure, if anyone has had that done (their experiences and success).
Many thanks.

@lisalucier hi to all. I am new to this discussion and group but have been involved in other groups on this site. I have map dot fingerprint which has been relatively quiet for a few years until recently. I have other major medical problems, which makes this feel overwhelming. Currently treated with drops, ointments and bandage lenses. I’ve had PTK surgery a few times to each eye but we are not there yet. I have a great medical team for the last 15 years after years of misdiagnosis and am fortunate and grateful to have the current team. I guess I am hoping to share experiences with others who have this or similar eye disorders. In the other groups on this site, I have found extraordinary comfort and support and I hope I can also offer my support to others. Best wishes to all. Rhoda

I have just been diagnosed with map dot dystrophy and have had the epithelial cells debrided from my right eye. Dr. tried to cover my cornea with a lense but I could not tolerate it. Had to go with taping eye shut. It is now 5 days later, don't have to tape eye, but still feels like there is something in the eye because of the irregularity of the epithelial cells. Does this stuff have to be debrided more than once sometimes before it gets better? How do all of you with this condition put up with the pain. It is debilitating. Uncomfortable does not begin to describe the sensation.

Hi, @bobr1040, and welcome to Mayo Clinic Connect. Glad to hear you have a diagnosis. The debriding and taping of your eye, and feeling like something is continually in your eye sound very unpleasant.

Here is an article with information from Mayo Clinic on map dot fingerprint dystrophy which may be useful: https://www.seattlepi.com/lifestyle/health/article/Medical-Edge-Ask-The-Mayo-Clinic-1252428.php

Hoping that members like @rckj @corinneh @IndianaScott @suscros68 @ryman will have some thoughts for you on this condition and on whether the debriding is needed multiple times. They may also have some insights for you on dealing with the pain.

Have you found anything that helps at all with the pain so far, bob1040?

@bobr1040 @lisalucier Hi, this is Rhoda @rckj I have map dot fingerprint corneal dystrophy and have had both good and difficult periods with it. I have a terrific ophthalmologist and surgeon who is a well known specialist in this on the east coast (Massachusetts). How can I be of help? Regards, Rhoda

Hi Rhoda - Thank you for your offer. At this point in time (the waiting game) my concern is if I have to have another debridement and the associated pain. What if anything did your Drs. give you for the pain. I cannot wear the contact lens after the debridement - my eye will not tolerate it. My Dr. says hydrocodone does not effect this type pain. I accept it might not effect the "scratched eye" pain but I know for a fact it will help with the other peripheral pain. I'm not a drug seeker. I just prefer to avoid continual pain. I would only need something for 4 - 7 days. Were you able to find anything to alleviate it while the healing process took place? What part did your surgeon play? Thank you, Bobr1040

Thank you for the article. I have not found anything for the pain and my Dr. does not want to prescribe hydrocodone. If I have to have another debridement I will demand the pain medication - for a one week period - or find another Dr. which will be too bad because he is a personal friend. However, I'm not going through the pain of a debridement again without medication. I understand that the pain medication may not stop the "sand in the eye" direct pain, it can deal with the peripheral pain. Has anybody had experience with various pain medications.

I am now 8 days out from the debridement and the "pain" is gone. It is now an irritation and I am using hypertonic eye drops daily and ointment at night. Vision is still blurry but getting better.

@bobr1040 hi, this is Rhoda @rckj. Sorry it took me a day to get back to you. Also, if you feel comfortable explaining to me what kind of peripheral pain you have, I might be able to answer your questions better. I have map dot fingerprint corneal dystrophy and have had two surgeries to each eye. I am temporarily stable but showing some signs that may lead to more surgery. I was misdiagnosed for many years until I found a corneal dystrophy specialist. He is really good and compassionate. If you are anywhere near Boston, I highly recommend him. Micheal Raizman, MD at Opthalmic Consultants of Boston. If you aren’t too far away I know an organization that flys patients to medical care free of charge. The surgeries I have had were all debridement plus use of the excimer laser to clear debris and promote healing. Yes, after all surgeries I had excruciating pain. Dr. Raizman explained the issue with opiates. The cornea is filled with nerves but has virtually no blood supply. So taking oral or IV painkillers will never work on the cornea because there is no blood supply to bring it to the cornea. It wasn’t an issue of withholding opiates because of all the current overreaction to opiate use. Patients in pain need should get opiates if they will help. I do, for another serious illness I have. They help with my other illness but not with the corneas. I researched corneal pain and I believe my doctor is right. But, opiates should work on peripheral pain that doesn’t originate in the cornea. All my peripheral pain was referred pain from the cornea so no help there. There are analgesic drops for surgeries and procedures but they can’t be used for post operative pain as they damage and degrade the cornea with any use other than procedures. Bandage lenses help me some as well as several drops that encourage the cornea to heal, plus antibiotic drops. Regarding bandage lens, they have to be carefully fitted and inserted, then kept moist with whatever drop your doctor recommends. Lubricant drops helped me but check with your doctor first. Also any lubricant drop must be preservative free, usually single use containers. I use Refresh Plus. Same brand ointment helped at night. But , yes, the pain was awful due to all those nerves in the cornea and no blood supply to deliver the opiates. I wish I knew what to say. Oh, it also helps to stay in dark rooms and use dark glasses. My doctor gave me dark glasses that fit over my regular glasses, which helped.Regarding peripheral pain, I saw a neuroopthamologist who confirmed, for me, that all the pain came from the cornea, after a series of simple tests. It was awful. I have taken hydromorphone (dilaudid) with minimal effect. I use self and guided hypnosis which helped some. I am a doctoral clinical psychologist who does hypnosis, so had access to those resources. Depending on where you are, I might know someone, if you want to try that. Basically I had to wait for healing. Did they use the laser as it does shorten healing time? Dr Raizman is one of the worlds experts on dystrophy and the laser. I’d be happy to call him for a referral in your area, if you decide to change doctors. Regarding “sand in the eye” feeling, lubrication helped. My doctor also put silicone punctal plugs in both lower lids. It blocks too rapid drainage of tears, keeping the cornea naturally moister. Sad to say, despite all the advice and my doctor warning me about the pain, it is awful and basically I had to ride it out. Dr Raizman kept a close eye on me and adjusted drops, etc. I am hoping you will write back and let me know what helped and what didn’t. I may also have more information on your peripheral pain once I understand what it is for you. All my best wishes and hopes for a speedier relief from pain. Regards, Rhoda.

Hi Rhoda! I'm Rachel and I found some of what you said very interesting. I have Fuch's dystrophy. I needed cataract surgery and cornea transplants when I was 43. Between the 2 procedures, my sensitivity to light was to have been dealt with. Unfortunately, it was not and grew worse. I know all about hiding out in the dark, living under hats and behind sunglasses. No more movie theaters, fireworks, concerts etc...Light sensitivity is normal during the healing time after surgeries but my healing apparently never ended. I used to drive home in the dark from work wearing dark sunglasses. Kept my cataract glasses for a long time. The snow and rain would make matters so much worse due to glare. It was very dangerous. Always worried about not seeing a pedestrian on the side of the road. My cornea specialist could never understand why this was and I was referred to a neuro-opthlemologist who blamed it on scar tissue from my past surgeries and oh yeah, I have blue eyes...what a crock! Last winter I finally threw in the towel. It's been 6 years now and each year has gotten worse driving at night. Sharp pains like daggers in my eyes on top of enducing migraines made me give up driving. Even as a passenger I need to wear hats and dark glasses and keep my eyes closed tight when car lights flash by. Often I may lay down in the back seat to avoid well lit areas, traffic lights and cars. This year I was diagnosed with small fiber peripheral neuropathy and can not help but wonder if the fact that there are a large amount nerve fibers in the corneas, it may be the contributing factor to my photophobia. Could neuropathy possibly do this? There is a cornea confocal microscope used for diagnosing SFPN so it only makes sense to me that there would be a connection.I have a message in to my neurologist to shed some light (no pun intended) and my cornea specialist has yet to weigh in. I'd appreciate your thoughts or anyones thoughts for that matter. Mayo Clinic in MN turned me down so why not ask here?Thanks a bunch and I hope you are having an uplifting day!!!
Rachel