
what is the
Cornea? | what
is EBMD? | who
is affected by EBMD?
| treatment
What is the Cornea?
The
cornea is the eye's outermost layer. It is the clear, dome-shaped
surface that covers the front of the eye. Although the cornea
is clear and seems to lack substance, it is actually a highly
organized group of cells and proteins.
Unlike most tissues in the body, the cornea contains no blood
vessels to nourish or protect it against infection. Instead,
the cornea receives its nourishment from the tears and fluid
(aqueous humor) that fills the chamber behind it. The cornea
must remain transparent to focus light properly, and the presence
of even the tiniest blood vessels or swelling can interfere
with this process. To see well, all five layers of the cornea
must be devoid of any cloudy or opaque areas.
What
is Epithelial Basement Membrane Dystrophy (EBMD)?
Epithelial Basement Membrane Dystrophy (EBMD) is a genetically
influenced abnormality, which causes small islands of the
corneas surface (epithelium) to improperly bond to the underlying
tissue. Similar to newly laid sod, these islands of unstable
tissue are susceptible to frequent erosions. Although not
typically sight threatening, corneal erosions can be a chronic
problem. They may alter the cornea's normal curvature, causing
periodic blurred vision. They may also expose the nerve endings
that line the tissue, resulting in moderate to severe pain
lasting as long as several days. Generally, the pain will
be worse on awakening in the morning, or during the night.
Other symptoms include sensitivity to light, excessive tearing,
and foreign body sensation in the eye.
Who
is affected by EBMD?
EBMD
usually affects adults between the ages of 40 to 70, although
it can develop earlier in life. EBMD tends to occur in both
eyes, although it is often asymmetric. It gets its name from
the unusual appearance of the cornea during your eye examination.
Most often, the affected cornea will have a map-like appearance,
i.e. large, slightly gray outlines that look like a continent
on a map. There may also be clusters of opaque dots underneath
or close to the map-like patches. Less frequently, the irregular
cornea will form concentric lines centrally that resemble
small fingerprints. Because of this unique appearance, it
is sometimes referred to as "Map-dot-fingerprint Dystrophy".
Is
there any treatment for Epithelial Basement Membrane Dystrophy?
Treatment for EBMD is palliative and is typically recommended
based upon patient symptoms. For non-symptomatic patients,
the application of artificial tears before bed is a general
recommendation. For patients with symptoms of visual disturbance
or frequent corneal erosion, our Doctors will prescribe treatment
ranging from simple eye medication and overnight eye patching
to punctal occlusion and laser corneal surgery. Statistically
about 10% of patients will develop symptoms usually after
the age of 30 years. The remainder are asymptomatic throughout
life.
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Treatment
for Epithelial Basement Membrane Dystrophy?
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Prophylactic eye lubrication
before bed and upon waking |
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Routine eye evaluation with
your eye doctor |
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Punctal
Plugs for more severe cases |
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Corneal laser surgery in the
extreme cases
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