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Epithelial basement membrane dystrophy (EBMD) is a disorder of the eye that can cause pain and dryness.EBMD, also known as map-dot-fingerprint dystrophy and Cogan microcystic epithelial dystrophy, is a corneal epithelial disease that may result in recurrent corneal erosions, irregular corneal astigmatism, and decreased vision.
It is a characterized by a breakdown or damage of the epithelium of the cornea in a pinpoint pattern, which can be seen with examination with a slit-lamp. Patients may present with non-specific symptoms such as red eye, tearing, foreign body sensation, photophobia and burning.
On inspection with a slit lamp, tiny lumps can be found on the cornea of the eye. These lumps can be more easily seen after applying fluorescein or rose Bengal dye eye-drops. The lumps appear to be randomly positioned on the cornea and they may appear and disappear over a period of time (with or without treatment). TSPK may affect one or both eyes.
On slit-lamp examination, conjunctival injections, epithelial corneal edema, [3] small to medium-sized fine keratitic precipitates, aqueous cells and flare may also be noted. [4] Blurring of vision, eye pain and discomfort are the main symptoms. [4] Colored halos may occur due to elevated IOP. [5]
Eye examination with the aid of a slit lamp. Side view of a slit lamp machine. Cataract in human eye: magnified view seen on examination with the slit lamp. In ophthalmology and optometry, a slit lamp is an instrument consisting of a high-intensity light source that can be focused to shine a thin sheet of light into the eye.
As a progressive, chronic condition, signs and symptoms of Fuchs dystrophy gradually progress over decades of life, starting in middle age. Early symptoms include blurry vision upon wakening which improves during the morning, [2] as fluid retained in the cornea is unable to evaporate through the surface of the eye when the lids are closed overnight.
Diagnosis is often by slit lamp examination after fluorescein dye has been applied. [1] More significant injuries like a corneal ulcer, globe rupture, recurrent erosion syndrome, and a foreign body within the eye should be ruled out. [1] Prevention includes the use of eye protection. [1] Treatment is typically with antibiotic ointment. [1]
Common findings on anterior segment slit lamp examination include increased cell and flare with associated fibrin and possible hypopyon formation. Patients may show signs of diffuse corneal edema , and they may also show signs of iris atrophy with pupillary abnormalities and eventual increased intraocular pressure.