Does an ophthalmologist look for Fuchs’ before cataract surgery?

Before cataract surgery, the cornea is evaluated as part of a comprehensive eye exam. Special testing for Fuchs’ dystrophy may include corneal thickness measurements and endothelial cell count.  This is not necessarily part of the pre-operative testing unless an abnormality such as guttata (deteriorated endothelial cells, which is a sign of Fuchs’) is found during the exam.  It is certainly possible that Fuchs’ dystrophy can exist without it being seen on the exam. 

So, in summary, the cornea is examined for abnormalities but special tests for Fuchs’ may not be done unless there is something on the exam to suspect that diagnosis. 

If you have a family history of Fuchs’ or have special concerns you should let your surgeon know and she might order additional testing.  However, if there are not clinical indications for this testing you could be responsible for the cost as it may not be covered by your insurance carrier.