Online Photo Diagnosis

By Gregory W. DeNaeyer, OD

This is a photograph of Lattice corneal dystrophy. This relatively rare stromal dystrophy is autosomal dominant and presents as refractile lines in the anterior stroma during the first decade of life. The lesions that create this lattice pattern consist of amyloid. As this dystrophy progresses, recurrent corneal erosions and scarring of the cornea are common. Treatments consist of bandage contact lenses or penetrating keratoplasty, depending on severity.

The 58-year-old patient featured in the photograph had best-corrected spectacle acuity of 20/200 and 20/40 in the right and left eyes, respectively. She suffered from severe epithelialopathy secondary to her advanced Lattice dystrophy. She was fit into scleral contact lenses (second image) to mask her irregularity and bandage her anterior surface. With the scleral lenses in place her acuity was 20/40 and 20/25 in the right and left eyes, respectively.

References

• DeNaeyer, GW. Diagnosing and treating corneal dystrophy Contact Lens Spectrum. June 2008.
• Kaufman, HE. Barron, BA. McDonald, MB. The Cornea. 2nd ed. Butterworth-Heinemann; 1998.