Retroillumination while the pupil is dilated is one of the easiest ways to view EBMD (Figure 1). Surface irregularity and rapid tear breakup time at the area of slightly elevated epithelium overlying the map-like changes, fingerprint lines, and/or microcysts in EBMD may reduce visual acuity. The pain can range from mild and lasting only a few minutes to severe and lasting hours or days or until treatment is initiated. RCE usually occurs after a traumatic abrasion in patients with or without EBMD. Recurrent corneal erosion (RCE) in EBMD can cause sharp pain, usually in the morning upon waking. The main symptoms of EBMD are typically ocular irritation, blurred vision, glare, photophobia, and pain. 1 EBMD tends to affect patients of all ethnicities and both sexes equally. EBMD is caused by dysfunction in the basal epithelial cells, resulting in a secretion of abnormal basement membrane that extends into the epithelium and an accumulation of fibrillogranular material between Bowman layer and the basement membrane and within the epithelium. The most common hereditary anterior corneal dystrophy is epithelial basement membrane dystrophy (EBMD), also known as map-dot-fingerprint dystrophy or anterior basement membrane dystrophy. This article presents some tips for diagnosis and management of these conditions, based on my own experience with them. As primary eye care providers, optometrists are uniquely positioned to diagnose and manage patients with corneal dystrophies. This group of noninflammatory inherited diseases can affect the transparency of the cornea.

Fuchs endothelial corneal dystrophy is the most common posterior corneal dystrophy, followed by posterior polymorphous dystrophy.Ĭorneal dystrophies are a result of abnormal cellular metabolism.Stromal dystrophies include lattice, granular, macular, and Schnyder corneal dystrophies.EBMD, also known as map-dot-fingerprint dystrophy or anterior basement membrane dystrophy, is the most common hereditary anterior corneal dystrophy.

Map dot fingerprint dystrophy