Epithelial Basement Membrane Dystrophy – Recurrent Corneal Erosions
Epithelial basement membrane dystrophy (EBMD), also known as map-dot dystrophy, is a bilateral, asymmetric, genetic condition that affects the cornea which is the front, clear layer of the eye. The cornea consists of 5 different layers that all work together to maintain the integrity of the cornea and provide a smooth, clear surface to allow light to reach the back of the eye uninterrupted which allows us our clear sight.
- EBMD is the most common of the corneal dystrophies and it alters the structural integrity of the cornea and makes it susceptibleto weakening.
- EBMD affects the adhesion between the top two layers of the cornea. This adhesion is weak in EBMD which causes the top layer, the epithelium, to exhibit changes and become slightly irregular.
- In EBMD, we know that the top layer of the cornea is weakly adhered to the layer below it because of poor anchoring fibrils that connect the top two layers.
- Over time the lack of adhesion and changes to the epithelium can build up leading to an increased risk of recurrent corneal erosions.
- Recurrent corneal erosions (RCE) occur when the weakened and poorly adhered epithelium sloughs off of the cornea which essentially leads to a scrape or scratch on the cornea.
- Symptoms of RCE are foreign body sensation, light sensitivity, redness, tearing, and blurred vision. These symptoms can be extremely unpleasant. Due to the cornea’s ability to heal itself rapidly, symptoms typically improve or resolve within a few hours of initial presentation.
- RCE’s occur most frequently in the middle of the night or in the morning upon awakening.
CORNEAL TREATMENT OPTIONS
Mile High Eye Institute are committed to providing our patients with the best and most up to date corneal treatment options for all eye conditions.
- Diamond burr keratectomy is a surgical procedure performed by Dr. Richheimer that eliminates the bad anchors and poor adhesive nature of the cornea and during the healing process the cornea replaces these poorly functioning components with new, strong anchors and improved adhesion.
- We also recommend a heavy topical lubrication regimen including artificial tears, ointments, and somtetimes Muro 128 topical solution.