Corneal guttata from Fuch’s dystrophy (Video)

This video shows a cornea with Fuch’s dystrophy. You can see guttata or guttae on the back surface of the cornea. These bumps indicate endothelial pump difficulty, and appear as a “beaten metal” appearance. If you look closely (look where the arrow is pointing) you can see a pock-marked surface that looks like craters on the moon.

Guttae are an important finding to note prior to cataract surgery, as this indicates a lower endothelial cell count and could lead to a decompensating cornea afer cataract extraction.

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guttata.wmv (4.6 meg, Windows video file)

Screencaptures

Fuches guttae
This photo of the cornea shows cornea guttae, small divots on the back surface of the cornea seen with aging and Fuches dystrophy.
Guttata
This photo, taken from our guttata video, shows guttae on the back surface of the cornea. These bumps are difficult to see, as you have to focus your microscope perfectly.
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Dr. Timothy Root is a practicing ophthalmologist and cataract surgeon in Daytona Beach, Florida. His books, video lectures, and training resources can be found at:

28 COMMENTS

  1. Good video. Theses guttata were very large and easy to see. It would be interesting to see a corresponding specular photomicrograph for comparative analysis.

  2. Good video. Theses guttata were very large and easy to see. It would be interesting to see a corresponding specular photomicrograph for comparative analysis.

    Yes, that would be interesting. Unfortunately, I don’t have access to a specular machine. Never really found them very useful, as I primarily look at corneal thickness (when determining risk for endothelial decompensation before cataract surgery).

  3. Nice movie. I wish to add a comment: actually this is a very advanced case and a high magnification slit lamp. Guttata in its early forms that needs detection is seen by focusing on the cornea at the region of reflected light from the iris, using what we call iris retroillumination.

    Thanks again for the efforts done.

    Regards

    Dr Moataz Attia
    MRCS Ed

  4. Benito 78 años:
    Tengo una guttata en el OD con una cantidad de células epiteliales inferiores a 1700.
    Debería operarme de catarata porque la visiona perdió nitidez y tengo dificultades visuales en la distancia.
    Los médicos tienen sus dudas en realizar la operación de catarata. Que me aconseja u/o donde podría dirigirme en Buenos Aires,

  5. I have corneal guttata and need cataract surgery. I live in Tallahassee, FL. Who in Fl or North GA has alot of experience with this?

    Thank You!

  6. I just had cataract surgery and now have been told I have corneal guttatae. What are my options now as vision as worsened? Is corneal transplant an option? If so, are there specialist in Austin, TX?

  7. I have just came upon the video as I have Fuch’s, will having cataract removed worsen my sight. Thanks for any help you can give C. Reed UK

  8. the hardest part is setting up the SL for specular reflection – it would have added immensely if that had been illustrated

  9. I have just been diagnosed with corneal gutatta. Is there treatment for this? My naturopath mentioned a connection to my hyperthyrod and thought if we get it under control it may help this condition. Your thoughts?

    Also what is the longterm prognosis for this?

  10. I am due to have a cataract removed late this summer. I have guttae. Any suggestions? I also have glaucoma. Should I have the surgery to remove the cataract?

  11. Next month I am facing guttata surgery. I need 2:nd opinion.
    Where do I find the best specialist. I had
    cateract surgery on same eye 10 years ago, now
    that implanted lens is becoming cloudy.
    Should I have lens “cleaned up” before the
    Guttata surgery.

  12. I found the information well explained and am curious to know. Due to Guttata and the decompensating cornea after cataract surgery should post operative results be excluded?

  13. I have a history of detached retina 2x in right eye. Very little vision left. Now I have been informed that I have Guttata in the left eye. What should I do?

  14. My husband has fukes dystrophy (guttae). I did extensive research to find the best. We travel from another state to see Ming Wang in Nashville, TN. We are very pleased with everyone in his office.

  15. I really wanted to get lazer surgery but found i had Guttata behind left eye,when i went for my consultation,he recomended i did not get the lazer surgery.what is your opinion?

  16. I was diagnosed w/guttata about 10 years ago. I’d had perfect eyesite until I hit 45 yrs old. I found out when I wanted to have eye surgery to improve my sight. I was informed that it was not a good idea because of this eye condition so I use my glasses. I am fortunate that I can see a specialist at UCLA yearly. He tells me my eyes are not getting worse. Only time will tell.

  17. I also have corneal gruttata and need cataract surgery. The retina specialist I see thinks its OK to have surgery but because I have a macular hole in the right eye am fearful of losing more sight in my Left eye any suggestions would be appreciated.I live in Phoenix AZ
    actchar2@yahoo.com

    • Charlotte,
      I can’t give direct medical advice in this venue. I recommend you speak to your cataract surgeon about the relative risk of your corneal guttae. While it is true that cataract surgery can exacerbate corneal Fuchs and cause decompensation, the risk may be outweighed by the benefit of the cataract removal … and allow future retinal surgery. Speak to your doctors!

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