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09/28/2025
Several years ago, my Ophthalmologist diagnosed me with Map Dot Fingerprint Dystrophy.
He has recommended lubricating eye drops as well as GenTeal Tears Gel drops.
He hasn't suggested an eye surgery.
What aggrevates my condition is too much computer screen viewing time.
When this happens, I cut back on computer screen viewing and good sleep helps resolve my eyeballs blurring, burning stinging and aching pain.
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My research
Map Dot Fingerprint Dystrophy
Epithelial basement membrane dystrophy is a disorder of the eye that can cause pain and dryness. EBMD, also known as map-dot-fingerprint dystrophy and Cogan microcystic epithelial dystrophy, is a corneal epithelial disease that may result in recurrent corneal erosions, irregular corneal astigmatism, and decreased
vision. It is sometimes included in the group of corneal dystrophies.
Map-dot-fingerprint dystrophy is an abnormality of the cornea (the clear front surface of the eyeball) in which the cells that cover the surface of the cornea do not retain the normal glassy smoothness of a healthy cornea. Rather, the cells on the surface become loosened from the underlying tissue and build up irregular
elevations in patterns that may resemble maps, dots, fingerprints, or other irregular surfaces. This is a dominant inherited trait in some families. Because the surface cells are loosened from the underlying tissue, the surface of the cornea can break down and create pain. There may be increased susceptibility to infection of the cornea as well. Be sure to maintain regular follow-up with your ophthalmologist.
Map dot fingerprint dystrophy (MDF), also known as epithelial basement membrane dystrophy (EBMD), is a condition affecting the cornea, the clear front surface of the eye. It is not directly related to or caused by the drug ethambutol. Ethambutol is primarily used to treat tuberculosis and may cause optic neuropathy, a
different condition affecting the optic nerve.
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@vipp
I have a thinning cornea so I asked chatGPT5 to comment on your post-
“you’ve gathered a good summary of map-dot-fingerprint dystrophy (epithelial basement membrane dystrophy, EBMD). Since you also note your thinning cornea, it makes sense to want to understand treatment options and the right specialists. Here’s how I’d break it down for you:
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🌟 Key Points About EBMD
• Mechanism: The corneal epithelium does not adhere properly to the basement membrane → irregular surface patterns (“maps, dots, fingerprints”).
• Symptoms: Dryness, fluctuating or blurred vision, recurrent corneal erosions (especially upon waking), light sensitivity, pain.
• Inheritance: Sometimes familial, sometimes sporadic.
• Not related to ethambutol (that causes optic neuropathy, not corneal surface disease).
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🔬 Treatment Approaches
Conservative / First-line:
• Lubricating drops/ointments: To reduce dryness and protect against erosions.
• Hypertonic saline (e.g., Muro 128): Draws fluid out of the cornea, helping epithelium stick more firmly.
• Bandage contact lens: For recurrent erosions, allows healing and comfort.
• Oral doxycycline (low-dose, anti-inflammatory) sometimes used for recurrent erosions.
Procedural / Surgical:
• Anterior stromal puncture (ASP): Creates tiny spots of adhesion to help epithelium anchor.
• Epithelial debridement with diamond burr polishing: Removes abnormal basement membrane and smooths corneal surface.
• Phototherapeutic keratectomy (PTK): Excimer laser ablation to remove irregular basement membrane and improve smoothness/vision.
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👨⚕️ Specialists to See
• Cornea specialist ophthalmologist (subspecialty training beyond general ophthalmology).
• At major centers like Wills Eye, Bascom Palmer, Cleveland Clinic, Mayo Clinic, Duke Eye Center, cornea specialists routinely treat EBMD and recurrent erosions.
• Since you already have corneal thinning, it’s especially important that a cornea subspecialist (not just a general ophthalmologist) follows you. Certain procedures (like PTK) must be balanced against corneal thickness.
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📌 Special Considerations With Corneal Thinning
• Thinning cornea can limit surgical options (e.g., PTK removes tissue).
• Aggressive lubrication and hypertonic saline may be preferred as first measures.
• Close monitoring is essential to avoid complications such as infection or perforation.
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👉 If you’d like, I can look up named cornea specialists at Mayo, Duke, or Cleveland Clinic who focus on epithelial basement membrane dystrophy and recurrent erosions.
Would you like me to compile a shortlist of leading cornea specialists at those centers so you know exactly who to ask for when scheduling?
Steven E. Wilson, M.D. — longtime cornea and refractive surgeon at Cleveland Clinic, leading corneal wound-healing research The Cole Eye Institute has a large cornea & external disease service with many expert physicians.
This is one of the major cornea centers in the U.S., with broad experience in advanced anterior segment and corneal surface
Sanjay V. Patel, M.D. — corneal specialist, corneal transplant & ocular surface work Keith H. Baratz, M.D. — corneal specialist with transplant interests
These are among the cornea faculty at Mayo; although their listed research is more on endothelial dystrophies, they are part of the cornea / transplant service.
Alan Neil Carlson, Corina Adela Busuioc, Christopher “Chris” Boehlke, Melissa B. Daluvoy, Kourtney Houser, Terry Kim, etc. — listed as Duke’s cornea/external disease faculty Duke’s cornea team handles dystrophies, ocular surface disease, transplantation.
If you go to Duke, you can ask for consultations with the cornea/external disease & refractive surgery division and ask for one of the above names.