Schnyder corneal dystrophy

Abstract

We present the case of a 45-year-old African male patient, who presented to the ophthalmic consultation for decreased bilateral visual acuity and complaints of blurred vision for 5 years. The ophthalmological examination included a measure of visual acuity using Snellen’s distance vision chart. We did a complete and bilateral biomicroscopic examination of the anterior and the posterior segments. The clinical examination found a reduced visual acuity to counting fingers in the right eye and 2/10 in the left eye. Intraocular pressure was normal in both eyes. Slitlamp examination revealed corneal arcus or a disk-like lesion and polychromatic crystalline depositions in both eyes in the subepithelial and the anterior 1/3 of the stroma (A). The mild onset of arcus lipoides was seen but the Midperipheral stromal haze was absent. Central corneal thickness results were 513 μm in the right eye and 509 μm in the left eye. A diagnosis of Schnyder corneal dystrophy was based on clinical presentation and the coexistence dyslipidemia of the patient. Schnyder corneal dystrophy (SCD) is a rare, autosomal dominant, anterior stromal dystrophy described as progressive bilateral corneal opacification due to abnormal accumulation of cholesterol and phospholipids in the cornea. SCD with different presentations may actually be misdiagnosed. Early diagnosis would help to rule out other potentially sight threatening or treatable conditions like infectious keratitis or drug toxicity. SCD should be discerned from other lipid keratopathies.