What is Map Dot Fingerprint Dystrophy?

Map Dot Fingerprint Dystrophy (MDF) is a hereditary disease of the “epithelium” or anterior “skin” cells of the cornea. Multiple names are used to describe this condition such as epithelial basement membrane dystrophy, Cogan’s microcystic dystrophy, or anterior membrane dystrophy. Redundancy of the cells within the epithelium leads the skin to form an irregular “fingerprint” or “map like” pattern sometimes containing cystic “dots”. These irregular areas may easily “erode” or break away from the underlying cells causing painful corneal abrasions commonly first noticed upon waking in the morning.

Symptoms

Diagnosis

Diagnosis usually occurs with a slit lamp examination of the cornea during your eye examination. In its earliest of stages, MDF can be subtle and is often missed without a very careful examination. Corneal Topography (mapping the shape) can aid in the diagnosis with characteristic irregular astigmatism from the irregular epithelium.

Treatment

Treatment depends on the severity of symptoms.  Early on MDF can just be monitored and does not require treatment.  If/When a patient’s vision becomes limited due to irregular astigmatism or painful corneal erosions occur, the irregular epithelium (MDF) can be removed and your eye will regenerate new, more healthy epithelium.

The procedure to remove the epithelium is called a Superficial Keratectomy (Super K). This is an in office procedure to remove the epithelium and any redundant subepithelial tissue with a spud and diamond burr instrument. A bandage contact lens is then placed to help with discomfort and healing. Patients typically have discomfort for the first few days and are sent home with antibiotic, steroid and artificial tear drops. Typical indications for this procedure include: Map Dot Fingerprint, Salzmann’s Degeneration and Recurrent Corneal Erosions (RCE).