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September 2011

What is this month's mystery condition?
Lattice Corneal Dystrophy
Written by Christopher Majka, MD, Lauren Welch, CPT, and Natalie Afshari, MD, Duke University Eye Center, Durham. N.C. Edited by Michael P. Kelly, CPT.

Photo by Lauren Welch, CPT, Duke University Eye Center.
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(PDF 313 KB)

September 2011 Blink

A 50-year-old male presented with a history of bilateral recurrent cor­neal erosions and decreased vision to the level of 20/100. Slit-lamp examination revealed glasslike refractile branching lines throughout the corneal stroma, a diffuse anterior stromal haze, and areas of epithelial irregularity.

Lattice lines typically begin in the center of the cornea in the anterior stroma and spread centrifugally and into the deeper stroma. The refractile lines are best visualized with a slit lamp using retroillumination or against a red reflex.

Unhappy with his visual acuity, the patient was seeking corneal trans­plantation. The patient did undergo successful penetrating keratoplasty with an improvement in visual acuity. Although to date there is no evidence of lattice corneal dystrophy in the graft, there is a continued risk of recur­rence, especially at approximately one decade after surgery.

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