Epithelial basement membrane dystrophy is a common corneal condition in which the surface epithelium and its underlying basement membrane develop small irregularities and map-like patterns. These changes can disturb the smoothness of the corneal surface.
Features and Symptoms
Many people are asymptomatic and the condition is found incidentally during eye examination. Others experience blurred or fluctuating vision, ghosting of images, or episodes of recurrent corneal erosion when the surface epithelium does not adhere properly.
- Also known as anterior basement membrane dystrophy or Cogan microcystic dystrophy
- Characteristic map, dot, or fingerprint patterns may be seen on slit-lamp examination
- Symptoms can be more noticeable on waking if erosions occur overnight
- Both eyes are often affected, though not always to the same degree
Management
Treatment aims to improve surface regularity and reduce erosions using lubricating drops, ointments at night, and sometimes hypertonic saline or bandage contact lenses. For persistent visual disturbance or recurrent erosions, procedures such as epithelial debridement, superficial keratectomy, or phototherapeutic keratectomy may be considered.
- Regular lubrication helps maintain a smoother ocular surface
- Patients with erosions may be advised to avoid sudden eye opening on waking
- Surgical options target the abnormal basement membrane to encourage firmer adhesion
- Long-term outlook is generally good with appropriate management
