Management of symptomatic Meesmann dystrophy.
Meesmann dystrophy is a non-progressive autosomal dominant corneal epithelial dystrophy characterized by intraepithelial cysts, which is likely to be caused by an intraepithelial metabolic abnormality. Cases may be asymptomatic or be associated with symptoms of irritation, lacrimation, and photophobia. Palliative treatment includes ocular lubricants, cycloplegia, and therapeutic contact lenses. In severe cases, management with epithelial debridement, phototherapeutic keratectomy, and lamellar keratoplasty has been advocated. Most recently, the genetic and molecular basis of Meesmann dystrophy have been explored, and mutations in the genes encoding corneal epithelial keratins have been reported. This report describes a case of Meesmann dystrophy with unusually severe symptoms and punctate epithelial keratopathy managed with a therapeutic contact lens.
Jalbert
Isabelle
I
School of Optometry and Vision Science, University of New South Wales and Institute for Eye Research, Sydney, NSW 2052, Australia. i.jalbert@unsw.edu.au
Stapleton
Fiona
F
D000328:Adult; D003261:Contact Lenses; D003316:Corneal Diseases / Q000175:diagnosis / Q000209:etiology; D003317:Corneal Dystrophies, Hereditary / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D003560:Cysts / Q000175:diagnosis / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D005799:Genes, Dominant; D006801:Humans; D018613:Microscopy, Confocal; D012720:Severity of Illness Index; D013194:Staining and Labeling; D014792:Visual Acuity