Map-dot-fingerprint-dystrophy, also called epithelial basement membrane dystrophy (EBMD) or Cogan’s microcystic dystrophy is a condition that affects the cornea. The cornea is the outermost layer of the eye and consists of a clear dome-like surface that covers the front of our eye. The cornea helps our eyes to focus.\
Risk Factors & Root Cause
Map-dot-fingerprint-dystrophy occurs when the bottom, or basement layer, of cells in the cornea thickens or become folded. The folds create grey shapes that look like continents on a map, as well as opaque dots. In some cases, these folds may form concentrically, and look like fingerprints.
As the basement layer thickens and folds it weakens the bond between these cells and the cells in the epithelium (the outermost layer of our corneas). If this bond becomes too weak the epithelial cells may become loose and slough off. It is most commonly found in adults between the ages of 40 and 70, though it can develop earlier.
Like other corneal dystrophies, map-dot-fingerprint-dystrophy is typically an inherited condition that affects both eyes. It progresses gradually and can happen to otherwise healthy individuals. Map-dot-fingerprint-dystrophy can also be caused by repeated or frequent eye trauma, which is why it is imperative that you undergo a full eye exam if you sustain any injuries to your eye.
Common Manifestations & Symptoms
Symptoms of map-dot-fingerprint-dystrophy include:
- Blurry vision
- Pain, particularly pain that is acute in the morning and lessens over the course of the day
- Sensitivity to light
- Excessive tearing
- Foreign body sensation
Symptoms typically flare up now and then over the course of several years and then go away without any loss of vision. Some individuals with map-dot-fingerprint-dystrophy may not even experience symptoms. However, some individuals may develop recurrent epithelial erosions, where the outermost layer of the cornea lifts away from the rest of the cornea, creating a small gap. This can cause your vision to become blurry because it alters the normal curvature of your cornea. Epithelial lifting can also expose the nerve endings that line the tissue, causing moderate to severe pain that can last several days.
Our Recommended Management
There are a variety of ways that map-dot-fingerprint-dystrophy can be treated. Your optometrist will recommend treatment based on your unique needs and the severity of your condition.
Hypertonic Eye Drop Solutions
Hypertonic eye drop solutions can sooth your map-dot-fingerprint-dystrophy by drawing excess water out of your cornea and reducing swelling. This can help restore your normal vision and reduce or eliminate your symptoms.
Salt Solution Ointments
Salt solution ointments work similarly to hypertonic eye drops. However, ointments are often recommended for overnight use because they don’t evaporate while we sleep. Symptoms of map-dot-fingerprint-dystrophy typically worsen overnight because our cornea tends to swell a little as we sleep. This is why individuals that experience pain because of map-dot-fingerprint-dystrophy usually find that the pain is worst in the morning.
Gas-Permeable Contact Lenses
Individuals that are experiencing changes in their vision because of dot-map-fingerprint-dystrophy may be prescribed gas-permeable contact lenses. These lenses can improve vision by creating a smooth, even corneal surface.
Your optometrist may recommend all or some of these treatments based on the severity of your symptoms and your individual needs.
Other Treatment Options
If ointments, eye drops, and contact lenses are not able to treat or mitigate your symptoms, your optometrist may recommend minor surgery. There are several surgeries available, and your optometrist’s recommendation will depend on the severity of your map-dot-fingerprint-dystrophy, your overall eye health, and your unique vision needs.
Anterior Corneal Stromal Punctures
An anterior corneal stromal puncture is a procedure that is used to help your corneal cells adhere better, reducing or eliminating pain and vision problems. This procedure is typically recommended for individuals with recurrent corneal problems.
Phototherapeutic Keratectomy (PTK)
Phototherapeutic keratectomy is a procedure that uses a laser to remove a small amount of corneal tissue. This smooths the surface of the cornea and corrects vision problems.
Depending on the severity of your map-dot-fingerprint-dystrophy your optometrist may recommend one or both of these minor surgical procedures. For more information about map-dot-fingerprint-dystrophy, or to request your next appointment, please contact our office.