Epithelial basement membrane dystrophy

Epithelial Basement Membrane Dystrophy

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Diagram of the human cornea, showing the location of the epithelial basement membrane.

Epithelial Basement Membrane Dystrophy (EBMD), also known as Map-Dot-Fingerprint Dystrophy, is a common corneal dystrophy affecting the corneal epithelium. It is characterized by the presence of abnormal basement membrane production, leading to a variety of corneal surface irregularities.

Pathophysiology

EBMD is caused by a defect in the basement membrane of the corneal epithelium. This defect leads to the formation of redundant basement membrane material, which can trap epithelial cells and cause them to become misaligned. The resulting surface irregularities can be seen as maps, dots, and fingerprint-like patterns on the cornea.

Clinical Presentation

Patients with EBMD may be asymptomatic or may present with symptoms such as blurred vision, recurrent corneal erosion, and discomfort. The condition is often discovered during a routine eye examination when the characteristic patterns are observed on slit-lamp examination.

Diagnosis

Diagnosis of EBMD is primarily clinical, based on the appearance of the cornea under slit-lamp examination. The characteristic map-dot-fingerprint patterns are usually sufficient for diagnosis. In some cases, corneal topography may be used to assess the extent of surface irregularities.

Management

Management of EBMD depends on the severity of symptoms. In asymptomatic patients, no treatment may be necessary. For those with recurrent erosions or significant visual disturbance, treatment options include:

• Lubricating eye drops to reduce discomfort.
• Hypertonic saline ointments to reduce corneal edema.
• Bandage contact lenses to protect the corneal surface.
• Anterior stromal puncture or phototherapeutic keratectomy (PTK) for recurrent erosions.

Prognosis

The prognosis for patients with EBMD is generally good, especially with appropriate management of symptoms. However, recurrent erosions can be a chronic issue requiring ongoing treatment.

Related Pages

• Corneal dystrophy
• Corneal erosion
• Phototherapeutic keratectomy