Which corneal dystrophy is most commonly associated with recurrent corneal erosions?

• A. Fuchs' Dystrophy
• B. Lamellar Dystrophy
• C. EBMD
• D. Macular Dystrophy

Answer: (C)

Recurrent corneal erosions arise when the epithelium fails to adhere properly to the underlying basement membrane. Epithelial basement membrane dystrophy does exactly that: it creates an abnormal, thickened basement membrane with irregular adhesion, so the surface epithelium easily slides off, especially with blinking or after waking. This leads to frequent, sometimes painful erosions and tearing in affected patients. The pattern seen on exam often includes map-dot-fingerprint appearances of the corneal surface, reflecting the irregular epithelial–stromal interface.

In contrast, Fuchs’ dystrophy is primarily an endothelial problem that causes corneal edema and bullae, not recurrent surface erosions. Macular dystrophy is a stromal dystrophy with central haze and scarring rather than recurrent epithelial breakdown. Lamellar dystrophy isn’t characterized by the epithelial adhesion defect that drives erosions. So the epithelial basement membrane dystrophy best fits the scenario of recurrent erosions.