Bilateral Central Corneal Opacity: Dystrophy or Degeneration?

Dr Pawan Prasher, Dr Baljeet Singh Dhillon.

Department of Ophthalmology, Sri Guru Ram Das Institute of Medical Sciences & Research, Amritsar, Punjab, India

Purpose: To present three unusual cases of bilateral central corneal opacities in which diagnosis regarding nature of opacities (dystrophy or degeneration) was difficult to establish.

Methods: We present three elderly patients (two 62 and 68 year old males and one 73 year old female) who presented to our clinic for routine cataract surgery and were found to have associated unusual bilateral corneal opacities.

Results: There was no significant previous ocular history including that of infection, trauma, surgery or long term drug intake for any systemic illness. All the patients showed bilateral subepithelial central, cloudy opacities of variable densities that morphologically did not confirm to any dystrophy or degeneration of cornea previously reported in literature. The remaining ocular examination was significant in terms of presence of associated cataracts in all three patients and glaucoma in one. The opacities were observed to be visually significant in all the cases. The systemic examination was unremarkable.

Conclusions: We report a unique case series of three patients not fitting into any of the previously reported categories of bilateral corneal opacities. This might represent a new entity of bilateral corneal opacities and warrant further histological, confocal and genetic evaluation to establish the true nature of unusual material deposited in the corneal stroma.