Granular corneal dystrophy is an inherited stromal dystrophy where discrete, crumb-like white deposits accumulate in the corneal stroma. The intervening cornea often remains relatively clear in early stages.
Clinical Appearance
Small, sharply defined opacities typically appear in the central cornea and increase in number and size with age. Vision may be little affected at first but gradually becomes blurred as deposits coalesce and scatter light.
- Usually affects both eyes symmetrically
- Deposits can become more confluent and extend deeper over time
- Some variants are associated with recurrent erosions and pain
- Slit‑lamp and imaging help distinguish it from other stromal dystrophies
Management
Treatment focuses on maintaining comfort and clarity. Superficial deposits may be treated with phototherapeutic keratectomy, while more advanced disease can require lamellar or full‑thickness corneal transplantation.
- Recurrence in grafts is possible, especially in certain genetic subtypes
- Long-term follow‑up guides timing of repeat interventions if needed
- Avoiding unnecessary corneal trauma can help reduce erosions
- Genetic counselling may be offered to affected families
