Eye Diseases

Epithelial Basement Membrane Dystrophy (EBMD)

Epithelial Basement Membrane Dystrophy (EBMD)


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.


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.


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".


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.