Basement membrane dystrophy AKA map dot dystrophy who here has this?

[Guest]

Well, I'll try to make it short and to the point. I finally got a solid diagnosis. Yes I have MGD, yes I have dry eye...but I also have a basement manbrane dystrophy. Now looking back on it, the very first doc I saw was right, she diagnosed me with map dot. However, I just didn't believe her because I was still in so much pain because she never addressed my tear film issues.

So if you saw my other post titled, everything was good until this morning. I had my first erosion in my left eye, well, my first erosion since the initial insult. I was very lucky, minor pain, extreme photophobia, but after only two days I'm pretty much back on track. So again, very grateful.

So so I guess I'm curious who else has this dystrophy...apparently this issue is the main cause of recurrent corneal erosions.

Has anyone had PTK or a debridement to fix the dystrophy? Was it successful?

Im noticing it is just so hard for us to get information because you vets are right, people come here distraught when things are bad and don't return when they get relief or move on.

Thanks to everyone thats helped me so far. I appreciate everyone on this site. This has been so hard for me to deal with. My entire life I've been a bodybuilder, the most extreme version of "healthy" you could imagine. I felt unbreakable, I took for granted how good it feels to feel good. This has just been so much harder because of my daughter. I feel like I'm somewhat of a burden on my wife and I feel like I won't be able to be the dad I dreamed I could be. I want this girl to see me as her hero, not some feeble guy with eye problems.

At the the same time I've been thinking, could my life have taken a different direction. Could I have known I had this and protected my eyes better? The answer is no...I didn't have the intelligence, access to doctors or the family history to warrant looking into an eye dystrophy. I am at least grateful that I can tell my daughter about all the mistakes we made before her...and make sure she has a better life. Free of needless suffering. Life is just crazy and not what I expected....I was just born too soon trying to smile, hope everyone is doing well!

[Guest]

Let me also state, once I'm on a solid path, I plan to continue to show up here regularly in hopes I can help someone else going through what I am. Again, thank you all!

[MGD1701]

Hi Dework

Epithelial basement membrane dystrophy (EBMD)
What are the differences from recurrent corneal erosion, rce

Found this info from http://eyewiki.aao.org/Epithelial_ba...rane_dystrophy

Management
The goal of management for EBMD is to improve vision and to reduce the rate of recurrence of recurrent corneal erosions. First line treatment options usually involve the use of nighttime lubricating ointments or hypertonic saline ointments.

Symptomatic erosions may be treated with bandage contact lenses, antibiotic ointments, or patching. There is some evidence that topical steroids or oral doxycycline may provide some benefit for patients with frequently occurring erosions. Various procedures such as anterior stromal puncture (outside the visual axis), YAG laser micropuncture, cautery, epithelial debridement and/or diamond burr polishing, and phototherapeutic keratectomy (PTK) can be of benefit in reducing the rate of recurrent erosions.

[Guest]

Ok, from my understanding it doesn't differ from RCE, it's a cause of RCE. So what happens is the epithelium doesn't anchor properly to the basement membrane. So when you look under a slit lamp you see these lines like a fingerprints and gray or white dots on the cornea. Looks like a map also, like with staining you can see shapes like countries on the eye, hence the name.

I dont know what to even say or do anymore. My left eye had a debridement already which is supposed to treat this issue. Problem is the doctor never addressed my inflammation or my MGD. So doing the procedure then was probably a mistake but I had no clue at the time.

Just confused and need need some guidance. This has changed my life so much I don't even know what to do anymore. I'm bipolar so I get suicidal at times...this is just really killing me. **** man!

[MGD1701]

Suggest to wear a pair of swimming google or a smiliar sort, when sleep
- none of doctors suggested it to me but I know it can help.
Think positively, you can manage it!

[Guest]

Suggest to wear a pair of swimming google or a smiliar sort, when sleep
- none of doctors suggested it to me but I know it can help.
Think positively, you can manage it!

Thank you, ill get on the goggles immediately.

[Hokucat]

Dowork, have you looked into scleral lenses? Map dot is one of the conditions sclerals treat. PROSE, EyePrintPro, or LaserFit are scleral brands who have doctors with extensive experience fitting patients with dry eye and related conditions. I wear my PROSE 12 hours a day.

http://www.bostonsight.org/PROSE/For...s-PROSE-Treats

[Guest]

Dowork, have you looked into scleral lenses? Map dot is one of the conditions sclerals treat. PROSE, EyePrintPro, or LaserFit are scleral brands who have doctors with extensive experience fitting patients with dry eye and related conditions. I wear my PROSE 12 hours a day.

http://www.bostonsight.org/PROSE/For...s-PROSE-Treats

Let me ask your opinion, clearly I have to make the final decision, just curious your thoughts.

If my eyes are doing pretty good right now, aside from this minor erosion, would you still suggest sclerals? More specifically, could implementing sclerals early in my treatment help resolve any future issues?

I ask bevause im really trying not to use any punctual plugs, sclerals, gas permeables, etc because I just don't like anything in or near my eyes like that. I also feel like sclerals are a final resort, maybe I'm not understanding the pros and cons of wearing them. Maybe I'm being close minded but I'll take any advice I can get lol.

[Hokucat]

I would say if you start getting recurrent erosions or if your eyes start getting drier, then look into it, but I wouldn't wait until it's really bad. It's sometimes tough to manage a condition, once it gets too far gone.

Sclerals are not so much a last resort anymore. They've actually become more mainstream, being worn by people who are opting for sclerals instead of regular contacts because of the superior correction in vision, and for some people it is very comfortable, especially unexpectedly the larger size lenses. Many local optometrist now offer them, but for dry eye conditions I would stick with the big guns for now. But you'll have to go for a consult and try them on to see if you can tolerate them. Some people cannot wear them. When my eyes were severely dry, I was one of those people.

I find that wearing my sclerals seem to make my eyes better while I'm not wearing them too, at least for a few days. Am guessing the saline keeping the corneas moist has therapeutic effects, like putting lotion on chapped skin. The lenses can help you manage your condition, so you don't keep getting erosions, and possibly the map dot condition willl lessen or go away, but those are things you'll have to ask the scleral specialist. Anyways, the lenses help me function much better...I'd be missing out on doing so many things with my husband and kids if I didn't have them.

[Guest]

I would say if you start getting recurrent erosions or if your eyes start getting drier, then look into it, but I wouldn't wait until it's really bad. It's sometimes tough to manage a condition, once it gets too far gone.

Sclerals are not so much a last resort anymore. They've actually become more mainstream, being worn by people who are opting for sclerals instead of regular contacts because of the superior correction in vision, and for some people it is very comfortable, especially unexpectedly the larger size lenses. Many local optometrist now offer them, but for dry eye conditions I would stick with the big guns for now. But you'll have to go for a consult and try them on to see if you can tolerate them. Some people cannot wear them. When my eyes were severely dry, I was one of those people.

I find that wearing my sclerals seem to make my eyes better while I'm not wearing them too, at least for a few days. Am guessing the saline keeping the cornea's moist has therapeutic effects like putting lotion on chapped skin. The lenses can help you manage your condition, so you don't keep jetting erosions, and possibly the map dot condition willl lessen or go away, but those are things you'll have to ask the scleral specialist. Anyways, the lenses help me function much better...I'd be missing out on doing so many things with my husband and kids if I didn't have them.

I'm trying to do everything possible to keep my eyes stable. I'm seeing pretty well after the erosion, this may seem weird. But I almost feel like that needed to come off. I'm seeing less halos and glare...it's odd. So my hope is the cornea heals better this time now that my tear film is much much better.

Ill look into sclerals, I just have a feeling a giant lens in my eye would make me feel worse. But again, maybe I don't understand how comfortable they can be if fitted correctly.

Thanks for the suggestions.

[EyesOpen]

In reading your post, Dowork, I think I was diagnosed with EBMD about the same month as you. My journey since diagnosis has been different, but the RCES that began in June, about a month after my cataract surgeries, have brought me to this forum.

I'm curious how you're doing now?

(I have been wearing the Onyx googles with foam inserts from the TranquilEyes as a pressure patch, which has been keeping my erosions to a minimum.)

[EyesOpen]

Hi Dework

Epithelial basement membrane dystrophy (EBMD)
What are the differences from recurrent corneal erosion, rce

Found this info from http://eyewiki.aao.org/Epithelial_ba...rane_dystrophy

Management
The goal of management for EBMD is to improve vision and to reduce the rate of recurrence of recurrent corneal erosions. First line treatment options usually involve the use of nighttime lubricating ointments or hypertonic saline ointments.

Symptomatic erosions may be treated with bandage contact lenses, antibiotic ointments, or patching. There is some evidence that topical steroids or oral doxycycline may provide some benefit for patients with frequently occurring erosions. Various procedures such as anterior stromal puncture (outside the visual axis), YAG laser micropuncture, cautery, epithelial debridement and/or diamond burr polishing, and phototherapeutic keratectomy (PTK) can be of benefit in reducing the rate of recurrent erosions.

Dowork, I'm understanding your pain!

I'm wondering, MGD1701, if you would do a PTK again, having "hind-sight?"
I ask because In a previous post (http://forum.dryeyezone.com/forum/ar...lial-prk/page2) you also talk about managing EBMD.

Right now, I'm avoiding RCES by sleeping with moistened foam inside Onyx goggles. While I'm thankful to be avoiding RCES, I'm bound to those goggles, and whenever I sleep or even nap without them, I have an erosion. I want to sleep without the goggles, but I don't relish such an invasive procedure.
No ointments, plugs, etc., have worked.

[Guest]

Dowork, I'm understanding your pain!

I'm wondering, MGD1701, if you would do a PTK again, having "hind-sight?"
I ask because In a previous post (http://forum.dryeyezone.com/forum/ar...lial-prk/page2) you also talk about managing EBMD.

Right now, I'm avoiding RCES by sleeping with moistened foam inside Onyx goggles. While I'm thankful to be avoiding RCES, I'm bound to those goggles, and whenever I sleep or even nap without them, I have an erosion. I want to sleep without the goggles, but I don't relish such an invasive procedure.
No ointments, plugs, etc., have worked.

I wonder if a debridement may be safer than ptk because there’s no laser involved. Have you had a debridement yet? I’ve had one in my left eye and because it wasn’t done properly, I actually got worse erosions. She cut only the top half of the cornea, so that left a line right in the center of my vision. Had she scraped the whole cornea, I think I would have been and still would be doing better. I have no clue why she did that.

So so all that said, I think if you get the diamond burr debridement from a specialist who does this a lot, it may be a better first option. With ptk, I’m prettt sure they do a debridement first, then zap the lower layer of the cornea with the laser.

[EyesOpen]

I wonder if a debridement may be safer than ptk because there’s no laser involved. Have you had a debridement yet? I’ve had one in my left eye and because it wasn’t done properly, I actually got worse erosions. She cut only the top half of the cornea, so that left a line right in the center of my vision. Had she scraped the whole cornea, I think I would have been and still would be doing better. I have no clue why she did that.

So so all that said, I think if you get the diamond burr debridement from a specialist who does this a lot, it may be a better first option. With ptk, I’m prettt sure they do a debridement first, then zap the lower layer of the cornea with the laser.

I thought I had a debridement at least once, when one ophthalmologist "debrided" the loose epithelial (from an erosion) prior to putting on a contact bandage. It was a quick procedure, after numbing drop, while I was sitting in the chair.

I honestly don't want to try the SK when I may need the PTK after all.

The current surgeon (my 2nd of two consultations) says the SK only has a 30% success rate, whereas the PTK has 95%. I haven't found any specific confirmation for this in my Google searches. I have read that the surgeon holding a diamond burr is less accurate than a laser.
This talks of some success rate of PTK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3661494/

[Guest]

I thought I had a debridement at least once, when one ophthalmologist "debrided" the loose epithelial (from an erosion) prior to putting on a contact bandage. It was a quick procedure, after numbing drop, while I was sitting in the chair.

I honestly don't want to try the SK when I may need the PTK after all.

The current surgeon (my 2nd of two consultations) says the SK only has a 30% success rate, whereas the PTK has 95%. I haven't found any specific confirmation for this in my Google searches. I have read that the surgeon holding a diamond burr is less accurate than a laser.
This talks of some success rate of PTK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3661494/

If you want I’ll get you some statistics...but from my research, diamond burr debridement has an 85% success rate. Not sure on ptk. I’m assuming that much and possibly higher. I just fear a laser hittting my eyes. That said, MGD had ptk and loved it. It stopped his erosions. So at the end if he day, you have to make the call. If I was having erosions constantly, I’d do just about anything to make them stop. I hope you post after the surgery, no matter what route you take. I’d like to see if the procedure helps. I wish you the best, erosions are horrible.