Dr. Shalu Pal

  • "If you want quality and wonderful service, please go to Dr. Shalu Pal! The patience, care, and true concern that Dr. Pal has for her clients is wonderful. "

    --Seleena J
  • " I was pleasantly surprised by finding a hidden gem within Dr. Pal's office"

  • "Finally a doctor who is extremely knowledgeable, patient and explains things clearly. She is a wonderful human being who really takes the time to care for your needs. The office has a wonderful atmosphere and the staff are just as helpful as Dr. Pal. "

  • "I couldn't ask for a better Optometrist. She is a delight to deal with, very patient, helpful and extremely knowledgeable. She was very good with my kids who can be very fussy at times.. And who could ask for a more beautiful location. Highly Recommend! "

    --Natalie M.
  • "My wife and I, highly recommend Dr. Pal. The staff, the service, the merchandise, are all top notch. They really make you feel welcomed. It has been several years since I have been able to see this well !!! You and your staff are the best !!!! "

    --Steve and Maria L.
  • "We barely go to optometrists so when we do, we should look for the best! I am super pleased I chose Dr. Pal\'s office. They were helpful from beginning to end, from booking on the phone to my actual visit. Dr. Pal was very detailed and went in-depth about my eye health. She is very patient and made me feel calm. The optician helped me pick a great pair of glasses, they were genuinely friendly which is a huge bonus."

    --Ahmad S
  • "I have been going to Dr. Pal for several years now. My most recent visit on June 6, 2016 was the best experience there that I have ever had. Firstly, the women on the desk were friendly and efficient - a very good prelude to my examination. Dr. Pal, herself, was, as usual, very thorough and encouraging in her examination. And she puts you at ease before we get into the eyes examination by discussing other things in life. That helps to ease any stress I may have. And they now have a man in the office who does that difficult examination (name of which I do not know!). He is so patient and encouraging and made the exam not so difficult for me this time. After all that, I saw Dr. Pal again before I left and she told me my eyes were good! Even had the news been not so good, I believe that I would be able to handle it because I truly believe that Dr. Pal and her staff would have taken good care of me. I will always go back to Dr. Pal and members of her team because I truly believe"

    --A. Howlett
  • " I have been to a few appointments at Dr. Pal\'s office over the last year for dry eye issues and every time it has been a very positive experience. The 3 receptionists at the front desk are warm and friendly. They are attentive and provide a very high level of customer service. I appreciate that they call me by name and remembered conversations we had at previous visits. I find Dr. Pal to be an excellent practitioner who is very thorough with her exams, has a lovely personality and takes the time to answer any and all questions that may arise. I am happy with the computer glasses I purchased and value the honest opinions I received from the staff when selecting frames. It was refreshing to have multiple opinions on styles and I felt they truly wanted me to walk out with a frame that was best suited to me. I highly recommend Dr. Pal \'s office! As a health care practitioner myself, I think all health care experiences should be this personilzed and friendly!"

    --A. Mclean
Epithelial Basement Membrane Dystrophy


Epithelial Basement Membrane Dystrophy


A corneal dystrophy is a non-infectious, non-inflammatory breakdown or deterioration of one or more of the five layers of the cornea, the clear, dome-shaped structure covering the front of the eye. The cornea is the first surface that light passes through on its way to the retina, so maintaining its smoothness and the regularity of its tissues is necessary for clear, undistorted vision. The outermost layer of tissue is the epithelium, a type of modified skin cell, which is attached to the next layer, the basement membrane. The basement membrane is also known as Bowman’s membrane or Bowman’s layer. (See illustration below.)

There are several corneal dystrophies, but by far the most common is "epithelial basement membrane dystrophy (EBMD), also known as map-dot-fingerprint dystrophy," because of its characteristic appearance in the biomicroscope, an optical instrument used by eyecare practitioners to evaluate the front parts of the eye. In the biomicroscope, it appears as an irregular pattern of cysts, ridges and circular whorls that resemble a map or a fingerprint.

It is not fully understood why certain corneas become dystrophic, but some have strong hereditary inclinations, are usually bilateral and that can be progressive. EBMD generally occurs after the age of 40, but can appear as late as age 70.


In EBMD, the basement membrane becomes thickened and irregular, causing the epithelium to buckle, wrinkle and break apart, so that the cells are easily dislodged from the surface of the cornea. The epithelium cells can break away and slough off, triggering symptoms of light sensitivity, blurred vision and discomfort. Patients with EBMD may also experience redness and irritation, ranging from mild to rather severe pain.

Because the eye does not blink and lubricate itself during sleep, symptoms are usually worse at the start of the day, improving somewhat as the day passes. In this aspect, EBMD is similar to "recurrent corneal erosion," a condition usually associated with improper healing after sustaining a corneal abrasion or injury.

EBMD is usually not progressive, but can be extremely variable in the way it affects the vision, and fluctuates over time. It can show up in just one eye, although it is usually bilateral. It can also be very asymmetric, effecting one eye more than the other.


The first course of action is to augment the natural lubrication of the eye, using artificial tears during the day and ointments or gel lubricants at night. (This is because thicker lubrication modalities blur vision.) Hypertonic saline solutions, which contain more salt than normal tears, are also useful; lubricants are usually recommended on a regular schedule throughout the day as well.

In more severe cases, patients may need to use a soft contact lens as a bandage to protect the epithelium. Increasing humidity in the home using vaporizers or similar equipment may be recommended.

More permanent treatments include puncturing the corneal epithelium to allow better adherence of the epithelial cells, corneal scraping to remove eroded areas and allow regeneration of healthy epithelial tissue. Sometimes, the excimer laser may be used to remove surface irregularities.

Summing Up

Most cases of EBMD are easily managed and patients remain comfortable and abrasion-free. It is important, however, for patients with any type of corneal irregularities or dystrophies to be diligent in using the proper lubricants and to stay in close contact with their eyecare practitioner. By doing so, loss of epithelial cells can be kept to a minimum or prevented, which helps decrease symptoms and discomfort associated with EBMD.

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