Christophe Baudouin, MD, PhD, FARVO
Quinze-Vingts National Eye Hospital & Vision Institute
University Paris Saclay
Paris, France

Basement Membrane Dystrophy is often responsible for recurrent erosions occurring in the morning after a night time when tears are rare and eyelid partially sticks to the cornea. DED may further increase the risk of corneal damage and mechanical stress. This case shows the association of the two conditions with a typical wave keratopathy and irregular epithelial surface. Tear film is therefore likely to spread unevenly over the cornea and eyelid rubbing to create additional epithelial damage. MMP activation through inflammatory cytokine release may also participate to this chronic  combination of osmotic / mechanical / neurogenic / inflammatory stresses.