Eye Case of the Week


This patient presents with transient blurred vision, foreign body sensation and watery eyes. Why?


Cogan’s Map-Dot-Fingerprint dystrophy (Epithelial Basement Membrane DystrophyEBMD)

Epithelial dystrophy: Basement membrane is thickened and extend into the epithelium (forming map and fingerprint)


  • Fingerprint lines (fine, relucent, hairlike lines)
  • Map lines (thicker than fingerprint lines, more irregular, surrounded by faint haze; resemble irregular coastlines/geographic borders)
  • Dots or microcysts (intraepithelial spaces containing debris of epithelial cell that have collapsed and degenerated before reaching epithelial surface)
  • Bleb or cobblestone-like pattern
  • Often have recurrent epithelial erosions
  • May cause irregular astigmatism


  • Educate and warn about recurrent corneal erosion – treat with lubricants
  • Recurrent corneal erosions with epithelial defect – treat with chlorsig drops/ointment QID prophylactic
  • Address blepharitis and dry eye if needed
  • Surgical
    • Epithelial debridement
    • Anterior stromal puncture
    • PTK