Anterior corneal dystrophies

ANTERIOR DYSTROPHIES

Epithelial basement membrane dystrophy
Also known as Cogan's microcystic dystrophy and
map-dot finger print dystrophy, is the most common
of all corneal dystrophies seen in working age adults.
The typical lesions, involving corneal epithelium, are
bilateral dot-like microcystic, or linear finger-print like
opacities. Most cases are asymptomatic. However,
about 10 percent patients develop recurrent corneal
erosions and experience severe disabling pain.
Treatment consists of patching with plain ointment
for 1-2 days. The condition remits spontaneously,
but can recur.

Reis-Buckler dystrophy
Also known as ring-shaped dystrophy (due to the
typical lesion) primarily involving the Bowman's layer
is a progressive corneal dystrophy occurring in
childhood. It has got autosomal dominant inheritance.
Most patients get frequent attacks of recurrent corneal
erosions that usually result in diffuse anterior
scarring.
Treatment. In early cases is same as that of recurrent
corneal erosions, i.e. by patching. However, most of
the patients ultimately need lamellar or penetrating
keratoplasty.

Meesman's dystrophy
(Juvenile epithelial dystrophy)
It is characterised by the presence of tiny epithelial
cysts.The disease occurs in early life and has
autosomal dominant inheritance. In most cases,
condition is asymptomatic and does not require
treatment.

Recurrent corneal erosion syndrome 

It is often described as a type of dystrophy that
typically follows trauma to cornea by finger nail or
any other sharp edge. It has been shown that a lack
of basement membrane and hemidesmosomes in the
area of involvement, is the basic underlying cause.
The condition is characterised by pain, photophobia,
lacrimation and blurring of vision on awakening in
the morning.
Treatment. It consists of patching with plain ointment
for 1-2 days. Hypertonic saline drops or ointment
decrease attack of erosions by reducing epithelial
oedema. Severe cases may be treated by scraping the
whole epithelium followed by pressure patching.

Stocker-Holt dystrophy
It is characterised by the presence of grey white dots
and serpiginous lines between epithelium and
Bowman's layer. The inheritance is autosomal
dominant. The condition may occur at any age from
one to seventy years.