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Granular Corneal Dystrophy!


•Autosomal dominant disorder.

•Mutation in the TGFBI (Transforming growth factor beta-induced) gene on chromosome 5q31.

•Begins in Early childhood (2 years) and has a very slow progression.


•Glare and photophobia.

•Visual acuity is affected in late stages when the opacities become more confluent.

•Painful recurrent erosions are rare.


•Well-defined white discrete irregular granular opacities (snow-flake appearance) with clear intervening stroma within the central anterior stroma.

•Periphery is spared.


•Deposition of HYALINE in the corneal stroma that stains bright red with Masson trichome.


•Asymptomatic patients: no treatment required.

•Mild ocular irritation: Preservative-free lubricating eye drops.

•Acute corneal erosions: Topical broad-spectrum antibiotic eye drops and preservative-free lubricating eye drops. Overnight patching with broad-spectrum antibiotic ointment and cycloplegic.

High oxygen transmissible BCL.

•Recurrent corneal erosions: Epithelial debridement, Excimer laser PTK, DALK or PK in advanced cases.⁣

Image from Rajan Eye Care Hospital⁣

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