Case report assisted and written by Niddhi Patel from the Illinois College of Optometry. Presumed graduation date of May 2025.
A 66-year-old white male presented with complaints of progressively worsening blurry vision and halos over the past three years. His condition had significantly impacted his daily activities, including difficulty reading music sheets and barely passing his CDL (commercial driver’s license) vision test this year.
**Clinical Findings**:
– **Diagnosis**: Epithelial Basement Membrane Dystrophy (EBMD) OU with central corneal scarring OD.
– **Best-Corrected Visual Acuity (BCVA)**:
– OD: 20/60 with spectacles due to central scarring and irregular astigmatism.
– OS: 20/20 with spectacles.
**Treatment Considerations**:
Surgical intervention was discussed as a potential option for managing corneal scarring. However, due to concerns about delayed wound healing associated with the patient’s condition, surgery was not pursued.
**Treatment Plan**:
The patient was evaluated for scleral lenses to address his visual complaints. After being fit with custom scleral lenses:
– BCVA improved to 20/20 OU.
– Scleral lenses were also prescribed to provide continuous corneal hydration and mechanical protection, thereby reducing the risk of recurrent corneal erosions—a common complication of EBMD.
**Outcome**:
The patient experienced significant improvement in both visual acuity and overall quality of life. He expressed satisfaction with his ability to see clearly and excited about renewing his CDL license without concern.
**Plan**:
The patient was instructed on proper scleral lens care and advised to follow up regularly for monitoring of corneal health, lens fit, and to assess for any potential complications. No further medical or surgical interventions were deemed necessary at this time.
