map-dot-fingerprint dystrophy; corneal epithelial basement membrane dystrophy

Epidemiology: 1) generally affects adults age 40-70 years Pathology: 1) abnormal development of epithelial basement membrane of cornea 2) corneal epithelial erosion (recurrent epithelial erosion) may result in blurry vision & eye pain Clinical manifestations: 1) most cases are asymptomatic 2) tends to occur in both eyes 3) blurry vision 4) eye pain a) may be severe b) may last several days c) generally worse on awakening in the morning 5) photosensitivity 6) excessive tearing 7) foreign body sensation 8) funduscopy: a) affected epithelium has map-like appearance b) slightly gray patches look like continents on a map c) clusters of opaque dots underneath or adjacent to patches d) irregular basement membrane may form concentric lines in the central cornea resembling fingerprints Management: 1) eye pain a) lubricating eye drops or ointments b) eye patch 2) surgery a) anterior corneal punctures to allow better adherence of epithelial cells b) corneal scraping to remove erosions c) eximer laser to remove surface irregularities Prognosis: 1) erosions usually heal in 3 days, althouth periodic eye pain may last weeks 2) flareups generally last a few years, then spontaneously resolve

References

Map-dot-fingerprint dystrophy http://www.nei.nih.gov/health/cornealdisease/index.asp#j