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.
*OD, PhD, FAAO
†MCOptom, PhD, FAAO
School of Optometry and Vision Science, The University of New South Wales (IJ, FS), The Vision Cooperative Research Centre (IJ, FS), and The Institute for Eye Research, Sydney, Australia (IJ, FS).
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This work was supported by the Australian Government through the Cooperative Research Centre scheme, by the Institute for Eye Research and by the Contact Lens Society of Australia.
Received February 21, 2009; accepted May 26, 2009.