This is a patient with Map-dot-fingerprint dystrophy, otherwise known as Cogan’s dystrophy. Map-dot-fingerprint dystrophy is the most typical form of corneal dystrophy. This disorder typically occurs bilaterally in adults from 40-70 years of age when the basement membrane of the corneal epithelium fails to develop properly resulting in sloughing off or failure of the epithelial cells to adhere to the basement membrane. When this occurs, the cornea erodes, altering the normal optical properties resulting in altered or blurred vision. It may also be painful as nerve endings are exposed by the corneal erosion.
Map-dot-fingerprint dystrophy is commonly recurrent, coming back every few years then resolving completely with no loss of vision and in fact, many cases are not severe enough for the patients to recognize that there is something wrong. No treatment is typically necessary, unless there is pain, though medical intervention can resolve the flareups faster than with no treatment.
This photo was taken using sclerotic scatter illumination by James Gilman of the Moran Eye Center using a Zeiss photo slitlamp and a Nikon D-1X camera.