Avellino Corneal Dystrophy

Avellino corneal dystrophy is a genetic eye condition. A change (mutation) in the TGFBI gene makes a sticky, abnormal protein collect in the clear front window of the eye (the cornea). Over many years, tiny white and gray crumb-like spots and thin lines build up in the middle layer of the cornea (stroma). These deposits scatter light, so vision can blur and glare can bother you, especially at night. The cornea can also erode (a tiny surface break), which causes sharp pain, watering, and redness. The problem usually affects both eyes and can slowly get worse. Glasses do not remove the deposits. Lubricants, bandage contact lenses, and laser polishing (PTK) can help symptoms. In advanced cases, a partial-thickness or full-thickness corneal transplant may be needed. The condition can come back even after surgery, because the underlying gene change stays. Laser vision correction (like LASIK) can make this disease much worse and is usually not recommended. JAMA Network+4EyeWiki+4EyeWiki+4

Avellino corneal dystrophy is a rare, inherited eye disease. It affects the cornea, which is the clear, front “window” of the eye. Tiny white bits (called deposits) build up inside the cornea over time. These deposits are made of two kinds of material: a glassy “hyaline” material and a protein clump called “amyloid.” Because both types are present, doctors sometimes say this disease looks like a mix of two other dystrophies (granular and lattice). The disease usually runs in families in an autosomal-dominant way. That means a child can get it if only one parent carries the gene change. Most people notice problems in the teenage years or in early adult life. The most common gene change is called TGFBI p.R124H. It changes how a corneal protein (keratoepithelin) behaves, so the protein clumps and settles in the cornea. Over many years, the cornea can get cloudy. Vision can blur. Some people also have painful “erosions” when the corneal surface loosens. Eye laser surgery like LASIK can make the disease flare and get worse quickly, so screening and counseling are important before any refractive surgery. ScienceDirect+4NCBI+4PMC+4

Other (alternative) names

This condition is known by several names. You may hear any of these used in clinics or articles. All point to the same disorder:

• Avellino corneal dystrophy (ACD)

• Granular corneal dystrophy type 2 (GCD2)

• Type II granular corneal dystrophy

• Combined granular–lattice corneal dystrophy
  These names reflect its first description in families from Avellino, Italy, and the mix of granular and lattice-like deposits seen on the cornea. EyeWiki+2orpha.net+2

Types

Doctors often describe two main patient groups and a spectrum of stages:

1) Heterozygous GCD2 (one changed gene).
This is the most common form. People develop small, sharp white dots in the front to middle cornea in childhood or early adulthood. With time, star-shaped or linear “lattice-like” lines may appear deeper in the cornea. Vision may stay good for years, then slowly blur. Recurrent erosions can cause pain. EyeWiki+1

2) Homozygous GCD2 (two changed genes).
This form is less common and more severe. Deposits are denser, appear earlier, and vision drops faster. Treatment is needed sooner in life. AAO

Stage pattern (early → late).
Early: few small deposits; Middle: more deposits with “stellate” shapes; Late: widespread haze through the stroma with mixed granular and lattice features. EyeWiki+1

Causes

Avellino corneal dystrophy has one main cause: a specific inherited gene change. Many other things below do not “cause” the disease by themselves, but they can trigger earlier onset, worsen, or unmask the disease. I’ll list them clearly.

1. TGFBI gene mutation (p.R124H) – the primary cause. It changes a corneal protein so it clumps and deposits. Autosomal-dominant inheritance. PMC+1

2. Homozygous state (two copies of the mutation) – leads to much more severe disease at a younger age. AAO

3. Other pathogenic TGFBI variants (allelic heterogeneity) – rarer changes in the same gene can produce similar mixed granular-lattice patterns. PMC

4. Family history (vertical transmission) – having an affected parent strongly raises risk because of autosomal-dominant inheritance. PMC

5. Age (time-dependent accumulation) – deposits grow slowly over years, so signs increase with age. EyeWiki

6. LASIK (flap-based laser surgery) – strongly associated with rapid, dramatic exacerbations and interface deposits after surgery. ScienceDirect+1

7. PRK/SMILE or other keratorefractive procedures – surface or lenticule procedures can also worsen deposit formation. Pre-op screening is recommended. PMC

8. Corneal trauma (mechanical injury or surgery) – injuries may trigger local healing responses and new deposits. (Inferred from postsurgical flares.) ScienceDirect

9. Contact lens wear after surgery – may not cause disease but can irritate a post-LASIK cornea with deposits; clinicians often monitor closely. (Clinical practice note supported by post-LASIK case series.) ScienceDirect

10. Dry eye and surface stress – can aggravate erosions and discomfort in eyes already affected. (General dystrophy care guidance.) BioMed Central

11. Inflammation after procedures – postsurgical inflammation may speed deposit visibility. (Inferred from exacerbation reports.) ScienceDirect

12. UV light exposure (theoretical co-factor) – not a proven cause, but many corneal diseases are managed with UV protection; clinicians advise sunglasses. (General corneal health principle.) BioMed Central

13. Recurrent epithelial erosions – repeated surface breaks can worsen symptoms and haze over time. EyeWiki

14. Genetic background (population clusters) – higher rates reported in some East Asian populations; founder effects exist. PMC

15. Wound healing signals (TGF-β pathway) – the mutated protein interacts abnormally during healing, promoting deposits. ScienceDirect

16. Protein–matrix binding defects (periostin interaction) – the R124H change disrupts normal binding, favoring clumping in the stroma. PMC

17. Epithelium–stroma turnover – ongoing turnover lets new deposits form over time; this explains recurrence after corneal surgery. PMC

18. Keratoplasty (corneal transplant) recurrence – grafts may redevelop deposits because systemic gene expression continues. PMC

19. Post-LASIK corneal interface as a “trap” – deposits can collect at the flap interface and reduce vision. ScienceDirect

20. Lack of genetic screening before refractive surgery – missing a diagnosis allows procedures that can precipitate rapid progression. Nature+1

Symptoms

1. Blurry vision that slowly worsens as deposits expand. EyeWiki

2. Glare from lights, especially at night. EyeWiki

3. Halos around lights, making driving at night hard. EyeWiki

4. Photophobia (light sensitivity) due to irregular corneal surface. EyeWiki

5. Recurrent corneal erosions (sudden pain when the surface loosens). EyeWiki

6. Eye pain during erosions or after surgery. EyeWiki

7. Foreign-body sensation like “sand in the eye.” EyeWiki

8. Redness and tearing during erosions. EyeWiki

9. Fluctuating vision from surface changes and healing cycles. EyeWiki

10. Reduced contrast (vision looks washed out). PMC

11. Contact lens intolerance in some patients as surface becomes irregular. PMC

12. Faster blurring after LASIK/PRK if surgery triggers flare. ScienceDirect

13. Early onset in severe (homozygous) cases, even childhood. AAO

14. Slow progression over decades in typical heterozygous cases. EyeWiki

15. Vision drop despite clear eye surface because deposits sit deeper in the cornea. EyeWiki

Diagnostic tests

A) Physical examination (at the slit lamp and in the clinic)

1. Best-corrected visual acuity (chart test).
   Checks how clearly you see with glasses. Vision can drop as deposits grow. Doctors track change over time. (Standard clinical measure in corneal dystrophies.) BioMed Central

2. External eye inspection.
   The doctor looks for redness, tearing, squinting, and pain behaviors. Helps detect active erosions or irritation. (Routine eye exam.) BioMed Central

3. Slit-lamp biomicroscopy.
   This is the key bedside test. A bright microscope shows white, well-defined “granules” in the anterior to mid stroma and deeper lattice-like lines. Over time, general haze can appear. The mix of granular and lattice features suggests Avellino (GCD2). EyeWiki+1

4. Fluorescein staining of the surface.
   A safe dye reveals scratches or erosions. Positive staining supports recurrent erosion episodes. (Routine corneal surface check.) BioMed Central

5. Corneal sensitivity (cotton-wisp or esthesiometry).
   Surface nerve function is checked. Sensitivity may be normal or mildly reduced; it helps explain pain and healing. (Adjunct test in corneal disease.) BioMed Central

B) Manual/functional office tests

6. Refraction (glasses power test).
   Measures focusing power. Irregular deposits can cause astigmatism or shifting vision; this test shows how much glasses can help. (Standard refraction.) BioMed Central

7. Tear film assessment (Schirmer/tear breakup, clinical).
   Dry eye does not cause GCD2 but can worsen symptoms and erosions. Testing helps manage comfort and healing. BioMed Central

8. Contact lens over-refraction/fit evaluation.
   Some patients see better with specialty lenses despite surface irregularity. Fit assessment is part of non-surgical care. (Clinical practice.) BioMed Central

9. Photophobia and glare testing (clinical).
   Simple brightness/glare checks document light sensitivity and functional impact, especially for driving. (Clinical practice.) BioMed Central

C) Laboratory and pathological tests

10. Genetic testing for TGFBI mutations.
    This confirms the diagnosis. Most Avellino cases have the p.R124H change. Testing helps with family counseling and surgical planning. Buccal swab DNA tests can detect common TGFBI mutations and are used before refractive surgery in some centers. PMC+1

11. Family testing/cascade screening.
    Testing relatives can find at-risk family members early, guide monitoring, and prevent unsafe refractive surgery. PMC

12. Histopathology (after surgery or biopsy).
    If tissue is removed (for example, during a corneal procedure), the lab can stain it. Masson trichrome stains granular hyaline deposits; Congo red stains amyloid and shows apple-green birefringence. This mixed pattern matches Avellino. JAMA Network

13. Research assays (protein studies).
    In research settings, scientists study how the mutated protein binds the corneal matrix (e.g., periostin). These studies explain why deposits form but are not needed in clinic. PMC

D) Electrodiagnostic tests (usually normal; used to rule out other causes)

14. Electroretinogram (ERG).
    Measures retinal electrical response. It is usually normal in GCD2 because the retina is healthy. It may be used if vision seems worse than the cornea alone would explain, to rule out a retinal problem. (General ophthalmic principle.) BioMed Central

15. Visual evoked potential (VEP).
    Measures brain response to visual signals. Like ERG, it is typically normal in corneal dystrophies. It is used when doctors suspect additional optic pathway disease. (General ophthalmic principle.) BioMed Central

E) Imaging tests

16. Anterior segment optical coherence tomography (AS-OCT).
    Creates cross-section images of the cornea. It shows where deposits sit (anterior to mid stroma) and how deep they go. Helpful for planning surgery and tracking change. PMC

17. In vivo confocal microscopy.
    A very high-magnification scan that shows reflective granular bodies and lattice-like lines in living cornea. It helps document deposit size, shape, and depth. PMC

18. Corneal topography/tomography.
    Maps corneal shape and thickness. It detects irregular astigmatism and helps decide if specialty contact lenses might help. It is also used before any refractive procedure. eyerounds.org

19. Pachymetry (thickness measurement).
    Measures corneal thickness. It informs surgical planning and safety (important if considering surface procedures). eyerounds.org

20. Specular microscopy (endothelial cell imaging).
    Assesses the inner corneal cell layer. Endothelial counts are usually preserved in GCD2 but checking them aids surgical risk assessment. (General corneal surgery planning.) BioMed Central

Non-pharmacological treatments (therapies and other measures)

1. Education and disease counseling
   Knowing that Avellino dystrophy is inherited, long-term, and can recur after surgery helps you plan care, protect your eyes, and inform family members. Avoiding LASIK and seeking early help for erosions reduces complications and pain. EyeWiki+1

Purpose: Reduce preventable harm and anxiety.
Mechanism: Informed choices (no LASIK), early reporting of erosions, adherence to safe care plans. PMC

2. Frequent preservative-free lubrication
   Artificial tears and nighttime gel/ointment lower friction between the eyelid and the cornea, easing burning, foreign-body sensation, and reducing erosion risk. Preservative-free products are gentler for frequent use. EyeWiki

Purpose: Soothe the surface and reduce micro-trauma.
Mechanism: Add moisture and a slick layer so the epithelium glides under the lid during blinking and sleep. EyeWiki

3. Hypertonic (salt) drops/ointment (non-Rx)
   5% sodium chloride (e.g., Muro 128) can pull extra water out of the cornea to lessen swelling after erosions, making vision clearer and more comfortable, especially on waking. DailyMed+1

Purpose: Reduce corneal edema and morning blur.
Mechanism: Osmotic gradient draws fluid out of the corneal tissue. DailyMed

4. Bandage soft contact lens
   A doctor-placed soft lens acts like a protective “cover” over a fresh erosion so it can heal with less pain. Antibiotic cover is typically used while the lens is in place. AAO+2PubMed+2

Purpose: Pain relief and faster surface healing.
Mechanism: Shields the epithelium from eyelid shear forces during blinking. EyeWiki

5. Cold compresses during erosions
   Cool packs reduce pain and swelling during an acute erosion episode and make light sensitivity more tolerable. Royal Victoria Eye and Ear Hospital

Purpose: Comfort.
Mechanism: Vasoconstriction and numbing decrease inflammation signals. Royal Victoria Eye and Ear Hospital

6. Nighttime “lid hygiene” and ointment
   Gentle warm compresses and bedtime ointment can decrease morning sticking of the eyelid to the cornea, lowering the chance of an erosion on first blink. Review of Optometry

Purpose: Prevent recurrent erosions.
Mechanism: Smooths lid movement and stabilizes the tear film overnight. EyeWiki

7. Moisture chamber or humidifier
   A bedroom humidifier or moisture goggles reduce dryness at night—helpful if you wake with discomfort or blur. EyeWiki

Purpose: Relieve dryness that triggers erosions.
Mechanism: Higher ambient humidity slows tear evaporation. EyeWiki

8. Safety eyewear and trauma avoidance
   Even small scratches can trigger painful erosions, so eye protection during sports, yardwork, or dusty tasks is smart. EyeWiki

Purpose: Prevent epithelial injury.
Mechanism: Physical barrier to airborne particles and impacts. EyeWiki

9. Avoid LASIK/PRK
   Laser vision correction has repeatedly worsened Avellino dystrophy, causing rapid deposit buildup and vision loss. Pre-op screening and genetic history matter. PMC+2JAMA Network+2

Purpose: Prevent disease acceleration.
Mechanism: Laser flap/interface alters stromal biology and can trigger TGFBI protein aggregation. PMC

10. Phototherapeutic keratectomy (PTK)
    A precisely controlled excimer laser “polishes” the corneal front layers to remove deposits and smooth the surface, improving comfort and sometimes vision. Recurrence can still happen. EyeWiki+1

Purpose: Clear anterior deposits; reduce erosions and glare.
Mechanism: Ablates microns of tissue to a smoother, clearer plane. PMC

11. Superficial keratectomy (manual polishing)
    In some cases, a surgeon gently scrapes or buffs the superficial cornea to remove loose epithelium and smooth peaks causing recurrent erosions. escrs.org

Purpose: Reduce frequent erosions.
Mechanism: Promotes a flatter, better-adhered epithelial layer. escrs.org

12. Diamond-burr polishing of Bowman’s layer
    A tiny burr carefully smooths Bowman’s layer after debridement in severe recurrent erosion cases. Review of Optometry

Purpose: Long-term erosion control.
Mechanism: Improves epithelial basement membrane remodeling and adhesion. EyeWiki

13. Scleral lenses (specialist-fit)
    Large vaulting lenses hold a fluid reservoir over the cornea, shielding it and improving comfort and vision in select patients. optometrytimes.com

Purpose: Cushion the surface and enhance optics.
Mechanism: Continuous fluid bath reduces friction and masks irregularity. optometrytimes.com

14. Punctal occlusion (plugs)
    In dry-eye-dominant cases, closing the tear drains can keep more tears on the eye, easing burning and erosions. EyeWiki

Purpose: Increase tear retention.
Mechanism: Mechanical blockage slows tear outflow. EyeWiki

15. Amniotic membrane (in stubborn erosions)
    A doctor can place a biologic membrane to speed epithelial regrowth and calm surface inflammation. optometrytimes.com

Purpose: Promote rapid, quiet healing.
Mechanism: Growth factors and a smooth scaffold support epithelial migration. optometrytimes.com

16. Deep anterior lamellar keratoplasty (DALK)
    A partial-thickness transplant replaces the diseased stroma while keeping your own endothelium. It improves vision and comfort but recurrence can occur. EyeWiki+1

Purpose: Clear advanced, deep deposits with healthier tissue.
Mechanism: Surgical replacement of most stromal tissue. ScienceDirect

17. Penetrating keratoplasty (PK, full-thickness)
    In advanced scarring or if DALK is not feasible, a full transplant can restore clarity—but recurrence is still possible over years. EyeWiki+1

Purpose: Restore vision in advanced disease.
Mechanism: Replace the entire cornea with a donor cornea. ScienceDirect

18. Genetic counseling
    Family members may wish to discuss testing, future planning, and refractive surgery avoidance. ScienceDirect

Purpose: Informed family decisions.
Mechanism: Explains inheritance patterns and risks to relatives. ScienceDirect

19. Regular slit-lamp follow-up
    Scheduled checks catch new erosions, epithelial problems, and graft changes early—improving outcomes. EyeWiki

Purpose: Early detection and timely treatment.
Mechanism: Microscopic evaluation guides care before symptoms escalate. EyeWiki

20. Clinical-trial participation (future therapies)
    Early studies are exploring gene editing for TGFBI dystrophies; ask your specialist about local trials. Ophthalmology Times+1

Purpose: Access cutting-edge options.
Mechanism: CRISPR/Cas approaches aim to correct or silence mutant TGFBI in corneal cells. Nature

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Drug treatments

Important safety note: none of the drugs below treat the genetic cause of Avellino corneal dystrophy. They are used off-label to manage dry eye, erosions, inflammation, or post-procedure care, and dosing must be individualized by an eye specialist.

1. Sodium chloride 5% drops/ointment (hypertonic saline) — common brands include Muro 128®
   Class: Hypertonicity agent. Dosage/Time: Drops 1–2 drops up to QID; ointment at bedtime; follow label and clinician advice. Purpose: Reduce corneal swelling after erosions and on waking. Mechanism: Draws fluid out of cornea via osmosis. Side effects: Temporary stinging/burning. DailyMed+1

2. Carboxymethylcellulose artificial tears (PF)
   Class: Lubricant. Dosage: 1 drop QID or as needed; PF for frequent use. Purpose: Ease dryness, reduce friction and erosion risk. Mechanism: Viscous tear supplement stabilizes tear film. Side effects: Mild blur right after dosing. (General lubricant class; use per product label.) EyeWiki

3. Hypromellose or glycerin-based lubricants
   Class: Lubricant. Dosage: As directed on label; often QID and PRN. Purpose: Comfort and surface protection. Mechanism: Increases tear film thickness and dwell time. Side effects: Temporary blur. (Class guidance.) EyeWiki

4. Cyclosporine ophthalmic emulsion 0.05% (RESTASIS®)
   Class: Topical immunomodulator. Dosage/Time: 1 drop BID about 12 hours apart. Purpose: For co-existing inflammatory dry eye (keratoconjunctivitis sicca) to improve tear production. Mechanism: Decreases T-cell–mediated inflammation of the lacrimal functional unit. Side effects: Burning on instillation, redness. FDA Access Data+2FDA Access Data+2

5. Lifitegrast 5% (XIIDRA®)
   Class: LFA-1 antagonist (anti-inflammatory for dry eye). Dosage: 1 drop BID (12 hours apart). Purpose: Treat signs/symptoms of dry eye disease that worsen erosions. Mechanism: Blocks LFA-1/ICAM-1 interaction to reduce ocular surface inflammation. Side effects: Irritation, dysgeusia (unusual taste), blurred vision. FDA Access Data+2FDA Access Data+2

6. Prednisolone acetate 1% (e.g., PRED FORTE®, OMNIPRED®)
   Class: Ophthalmic corticosteroid. Dosage: Tapered per surgeon/doctor; often QID then taper. Purpose: Calm inflammation after PTK or erosions. Mechanism: Inhibits phospholipase A2; lowers prostaglandins/leukotrienes. Side effects: Raises eye pressure, cataract risk with prolonged use; infection risk. FDA Access Data+1

7. Loteprednol etabonate 0.5%/0.38% (LOTEMAX®/LOTEMAX® SM)
   Class: “Soft” steroid. Dosage: Post-op or short courses per label/doctor. Purpose: Control inflammation with lower average IOP risk versus some steroids. Mechanism: Corticosteroid receptor agonist with rapid inactivation. Side effects: IOP rise possible; avoid with active epithelial herpes. FDA Access Data+1

8. Moxifloxacin 0.5% (VIGAMOX®)
   Class: Fluoroquinolone antibiotic. Dosage: Typically TID–QID for epithelial defects or post-procedure prophylaxis per clinician. Purpose: Reduce bacterial risk when epithelium is open or a bandage lens is worn. Mechanism: Inhibits bacterial DNA gyrase/topoisomerase. Side effects: Local irritation; hypersensitivity. FDA Access Data+1

9. Gentamicin/prednisolone combo (PRED-G®)
   Class: Antibiotic + steroid. Dosage: As directed short term when inflammation coexists with surface infection risk. Purpose: Dual coverage after procedures or significant surface inflammation. Mechanism: Antibacterial protein synthesis inhibition plus steroid anti-inflammation. Side effects: IOP rise, delayed healing; must be supervised. FDA Access Data

10. Erythromycin ophthalmic ointment
    Class: Macrolide antibiotic ointment. Dosage: Usually bedtime on the lid margin/surface for lubrication/antibacterial cover in erosions. Purpose: Soothing protection and infection prevention during healing. Mechanism: Inhibits bacterial protein synthesis; ointment shields the epithelium. Side effects: Temporary blur; allergy is rare. U.S. Food and Drug Administration

11. Topical NSAID (e.g., ketorolac)
    Class: NSAID eye drop. Dosage: Short courses only under supervision. Purpose: Pain relief around procedures. Mechanism: COX inhibition lowers prostaglandin-mediated pain. Side effects: Rare corneal complications with unsupervised use; use sparingly. (Class risk based on labels/practice.) escrs.org

12. Cycloplegic (e.g., cyclopentolate) during acute erosions
    Class: Antimuscarinic. Dosage: Doctor-directed short course. Purpose: Pain relief by relaxing ciliary muscle and light sensitivity control. Mechanism: Temporarily paralyzes accommodation; dilates pupil. Side effects: Blurred near vision, light sensitivity. Royal Victoria Eye and Ear Hospital

13. Autologous serum tears (compounded; regulatory status varies)
    Class: Biologic tear substitute. Dosage: Often QID–Q6/day under specialist care. Purpose: Refractory surface disease or erosions. Mechanism: Provides growth factors and nutrients similar to natural tears. Side effects: Handling/infection risk; not FDA-approved as a drug product. optometrytimes.com

14. N-acetylcysteine (compounded topical)
    Class: Mucolytic. Dosage: Commonly 5–10% QID in filamentary keratitis when present. Purpose: Breaks mucus filaments and reduces pain. Mechanism: Disrupts disulfide bonds in mucins; anti-inflammatory effects. Side effects: Stinging; needs compounding. PubMed+1

15. Oxervate® (cenegermin-bkbj) 0.002%
    Class: Recombinant human nerve growth factor. Dosage: Q2H six times daily for 8 weeks (per label). Purpose: Only for neurotrophic keratitis, not Avellino itself, but sometimes relevant if corneal nerves are damaged. Mechanism: Promotes corneal nerve and epithelial healing. Side effects: Eye pain, inflammation. FDA Access Data+1

16. Short oral analgesics
    Class: Systemic pain relief (e.g., acetaminophen) during erosions. Dosage: Per package/physician. Purpose: Ease acute pain safely. Mechanism: Central analgesia; does not treat the cornea. Side effects: Label-based risks. (General supportive care.) Royal Victoria Eye and Ear Hospital

17. Prophylactic antibiotics while BCL in place
    Class: Topical antibiotic (e.g., moxifloxacin or ofloxacin) per doctor. Dosage: As directed for the duration of bandage lens wear. Purpose: Lower infection risk under the lens. Mechanism: Suppresses susceptible bacteria during healing. Side effects: Local irritation, allergy. Royal Victoria Eye and Ear Hospital

18. Short steroid course after PTK
    Class: Ophthalmic corticosteroid. Dosage: Taper over weeks as directed. Purpose: Reduce post-laser haze and inflammation. Mechanism: Anti-inflammatory action and scar modulation. Side effects: IOP rise, infection risk with prolonged use. FDA Access Data

19. Lubricating ointments (petrolatum/mineral oil)
    Class: Ophthalmic ointment. Dosage: HS (bedtime) commonly. Purpose: Night protection to prevent morning erosions. Mechanism: Occlusive barrier retains moisture and reduces adhesion to the lid. Side effects: Temporary blurring. (General class use.) EyeWiki

20. Topical antibiotic-steroid combos (short courses only)
    Class: Combination drops/ointments. Dosage: As directed for specific indications. Purpose: When inflammation and infection risk coexist (e.g., post-debridement). Mechanism: Dual action as above. Side effects: IOP rise; stewardship needed. FDA Access Data

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Dietary molecular supplements

Important: Supplements may help ocular surface comfort in some people but do not remove corneal deposits. Evidence for several is mixed.

1. Omega-3 fatty acids (EPA/DHA)
   Omega-3s may help some dry eye patients, but large trials show mixed or no clear benefit; some analyses suggest modest improvements in tear metrics over time. Dose ranges vary (often 1–3 g/day combined EPA+DHA). Talk to your clinician if you take blood thinners. New England Journal of Medicine+2JAMA Network+2

2. Vitamin C (ascorbic acid)
   Vitamin C supports collagen cross-linking and wound healing. Typical dietary intake or a standard multivitamin is usually enough; high doses can cause stomach upset or kidney stone risk in predisposed people. It does not treat deposits. (General wound-healing biology; use food-first approach.) EyeWiki

3. Vitamin A (not high-dose unless deficient)
   Adequate vitamin A supports healthy epithelium and tear film; deficiency causes severe dry eye. Avoid excess (toxicity risk). Food sources (eggs, dairy, leafy greens) are safest. EyeWiki

4. N-acetylcysteine (oral)
   As an oral antioxidant/mucolytic, NAC has been explored for mucus-related ocular surface issues; topical forms are far more studied. Typical oral doses (e.g., 600 mg once or twice daily) should be physician-guided. ScienceDirect

5. Flaxseed oil (ALA)
   Plant omega-3 (ALA) converts poorly to EPA/DHA; symptom benefit is uncertain. If used, discuss dose (often 1–2 g/day) and GI tolerance with your clinician. MDPI

6. Gamma-linolenic acid (GLA; borage/EV evening primrose)
   Some dry-eye studies pair GLA with omega-3; results are variable. Consider only with medical guidance due to drug interactions. ScienceDirect

7. Antioxidant blend (balanced multivitamin)
   A standard multivitamin/mineral can support general ocular surface nutrition; it will not treat corneal deposits. Avoid mega-dosing. (General supportive rationale.) EyeWiki

8. Hydration and electrolytes
   Adequate fluids support tear production and comfort; simple, safe baseline step. (General supportive care.) EyeWiki

9. Dietary anti-inflammatory pattern (Mediterranean-style)
   Eating more fish, vegetables, fruits, and whole grains may help systemic inflammation that can influence the ocular surface. Food-first approach preferred. ScienceDirect

10. Avoiding excess alcohol/smoke
    Alcohol and smoke exposure can worsen ocular surface dryness. Reducing both supports comfort. ScienceDirect

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Immunity-booster / regenerative / stem-cell” drugs

1. Cenegermin (Oxervate®) — approved for neurotrophic keratitis, not for Avellino. In select cases with severe nerve damage, it can help the surface heal. Dosing is Q2H, 6×/day for 8 weeks per label; doctor supervision is essential. FDA Access Data

2. Autologous serum tears — a compounded biologic, not an FDA-approved drug. Rich in growth factors; sometimes used for stubborn erosions or surface disease to improve comfort and epithelial stability. optometrytimes.com

3. Platelet-rich plasma (PRP) eye drops — another compounded biologic used in some centers to deliver growth factors to the surface in difficult cases; regulatory status varies by region. PubMed

4. Amniotic membrane devices — biologic coverings used in clinic to speed epithelial healing for erosions; they are devices/tissues, not drugs, but act regeneratively on the surface. optometrytimes.com

5. Limbal stem-cell therapy (Holoclar® in EU) — approved in Europe for limbal stem-cell deficiency (not Avellino). Shows what’s possible with epithelial stem cells; not approved in the U.S. for this indication. European Medicines Agency (EMA)+1

6. Gene editing (research stage) — early trials are exploring CRISPR-based approaches targeting TGFBI mutations. This is investigational and only in clinical studies. Ophthalmology Times

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Surgeries (what they are and why done)

1. Phototherapeutic keratectomy (PTK)
   Procedure: An excimer laser removes microns of diseased superficial tissue to smooth the cornea and reduce deposits near the surface.
   Why: To improve comfort, cut erosions, and sometimes sharpen vision when deposits are anterior. Recurrence over time is possible. PMC

2. Superficial keratectomy / diamond-burr polishing
   Procedure: The surgeon lifts loose epithelium and gently polishes the underlying layer.
   Why: To stop frequent erosions and create a better base for new epithelium to stick. Review of Optometry

3. Deep anterior lamellar keratoplasty (DALK)
   Procedure: Replaces most of the corneal stroma while keeping your own endothelium.
   Why: For deeper, visually significant deposits with relatively healthy inner layers; lowers some graft-rejection risks versus PK, though recurrence can occur. ScienceDirect+1

4. Penetrating keratoplasty (PK)
   Procedure: Full-thickness corneal transplant with donor tissue.
   Why: For advanced scarring or when DALK is not suitable; can restore clarity but deposits can recur years later. ScienceDirect+1

5. (Avoided) Laser refractive surgery (LASIK/PRK) in Avellino
   Procedure: Vision-correction laser surgery.
   Why not: Strong evidence links LASIK/PRK to rapid worsening of Avellino dystrophy; therefore contraindicated in affected patients. PMC+1

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Prevention tips

1. Do not have LASIK/LASEK/PRK if you have Avellino dystrophy or family history. JAMA Network

2. Use preservative-free tears and bedtime ointment during dry spells to reduce erosions. EyeWiki

3. Treat erosions early—see an eye doctor for pain, tearing, or sudden blur. EyeWiki

4. Wear eye protection for sports, DIY, or dusty work. EyeWiki

5. Humidify your bedroom or use moisture goggles if mornings are rough. EyeWiki

6. Follow post-laser or post-surgical drop plans exactly to lower haze, infection, and recurrence risk. FDA Access Data

7. Avoid rubbing your eyes, which can trigger erosions. EyeWiki

8. Keep follow-up appointments to monitor for recurrence after PTK or transplant. PMC

9. Share family history and diagnosis with clinicians before any eye procedure. ScienceDirect

10. Consider genetic counseling for relatives who might be at risk. ScienceDirect

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When to see a doctor

• Right away: sudden sharp eye pain, tearing, light sensitivity, or the feeling of a cut in the eye (possible erosion); sudden blur or haze; redness with discharge; pain after a recent procedure; or a contact lens stuck on the eye. EyeWiki

• Soon (days): increasing glare or night halos; frequent erosions; worsening dryness despite lubricants. EyeWiki

• Routine: every 6–12 months for slit-lamp checks if stable, and earlier after PTK/DALK/PK to spot recurrence. PMC

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What to eat” and “what to avoid

What to eat:

1. Hydrating foods and fluids throughout the day to support tear film. EyeWiki

2. Fish (e.g., salmon, sardines) once or twice weekly as part of an overall anti-inflammatory diet. Evidence for omega-3 supplements is mixed; food-first is reasonable. New England Journal of Medicine+1

3. Plenty of colorful vegetables and fruits to supply antioxidants that support surface health. ScienceDirect

4. Whole grains and legumes for steady energy and micronutrients. ScienceDirect

5. Nuts and seeds in moderation for healthy fats. ScienceDirect

What to avoid/limit:

1. Smoking and smoke exposure, which worsen ocular surface dryness. ScienceDirect
2. Excess alcohol, which can dehydrate you and irritate the eyes. ScienceDirect
3. Very spicy/salty late-night foods if they worsen morning dryness; focus on hydration. EyeWiki
4. Over-the-counter decongestant eye drops for “redness relief” (can rebound-red). Use doctor-recommended lubricants instead. EyeWiki
5. Unverified “miracle” supplements online—discuss with your doctor first. Evidence is mixed for many products. New England Journal of Medicine

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Frequently asked questions

1. Can drops cure Avellino dystrophy?
   No. Drops help comfort and healing but do not remove genetic protein deposits. Surgery or laser is used when deposits affect vision. EyeWiki

2. Will it come back after PTK or transplant?
   It can. Recurrence has been reported after both PTK and corneal transplantation, often over years. PMC+1

3. Is LASIK safe for me?
   Generally no—LASIK/PRK can worsen Avellino dystrophy and is usually avoided. JAMA Network

4. Do artificial tears help?
   Yes. They reduce friction and discomfort and can lower erosion risk when used regularly. EyeWiki

5. Are hypertonic drops useful?
   Yes, especially for morning blur from corneal swelling after an erosion. DailyMed

6. Why do erosions hurt so much?
   The corneal surface breaks and exposes sensitive nerves; blinking rubs the raw area. Bandage lenses and proper drops speed healing. EyeWiki

7. Are steroids safe?
   Short courses under supervision can help after procedures, but long use can raise eye pressure and infection risk. Follow your taper exactly. FDA Access Data

8. Do omega-3 pills fix my eyes?
   Evidence is mixed; some studies show little to no symptom benefit. A fish-rich diet is reasonable; ask your doctor before supplements. New England Journal of Medicine+1

9. Can gene therapy cure this?
   Not yet. Clinical research is under way to target TGFBI with CRISPR-based approaches. Ophthalmology Times

10. Will my children get it?
    Avellino dystrophy is typically autosomal dominant, so a child has a 50% chance if one parent carries the mutation. Genetic counseling can help. ScienceDirect

11. Do scleral lenses help?
    They can improve comfort and vision in select cases by bathing the cornea in fluid. Specialist fitting is needed. optometrytimes.com

12. Is Oxervate® for me?
    It treats neurotrophic keratitis, not Avellino itself. Your doctor will decide if you have that condition. FDA Access Data

13. Will serum or PRP drops cure my dystrophy?
    No—they may ease surface disease and erosions but do not remove TGFBI deposits. optometrytimes.com

14. How often should I follow up?
    Typically every 6–12 months when stable; sooner after PTK/DALK/PK or if symptoms flare. PMC

15. What’s the single biggest mistake to avoid?
    Having refractive laser surgery (LASIK/PRK) without telling the surgeon about Avellino in you or your family. JAMA Network

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: October 14, 2025.

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