Twenty percent of patients diagnosed with AK in this series carried a concurrent corneal diagnosis apart from HSV infection, including recent trauma, diabetic eye disease, atopy,
basement membrane dystrophy, epidemic keratoconjunctivitis (EKC), history of refractive surgery, crystalline keratopathy, or dry eye and rosacea keratoconjunctivitis.
Broad, angled slit beam examination of both eyes before and after administration of fluorescein should be performed, as well as a retro-illumination examination of the cornea with a dilated pupil to discern the often subtle signs of
basement membrane dystrophy or areas of previous erosion.
This is also known as map-dot-fingerprint dystrophy, Cogan microcystic dystrophy and anterior
basement membrane dystrophy. EBMD is more common in adults, rarely occurring in children, and doesn't followa pattern of inheritance.