Lattice corneal dystrophy: a source of confusion

Area of Science:

• Ophthalmology
• Genetics
• Corneal Diseases

Background:

• Lattice dystrophy of the cornea typically presents with a stereotyped clinical course.
• Published literature suggests a more varied presentation than commonly described.
• This study focuses on a family with an atypical form of lattice dystrophy.

Purpose of the Study:

• To describe a family with lattice dystrophy of the cornea.
• To highlight an unusually late onset and prolonged retention of useful vision.
• To investigate potential diagnostic challenges associated with subtle lattice line presentation.

Main Methods:

• Clinical case report and family history analysis.
• Ophthalmic examination including slit-lamp biomicroscopy.
• Documentation of visual acuity and corneal findings over time.

Main Results:

• A family with lattice dystrophy of the cornea presenting with late onset, with useful vision maintained into the 7th decade.
• Five family members were initially misdiagnosed with herpes simplex keratitis.
• Subtle lattice lines, visible primarily by retroillumination, were noted as a key feature.

Conclusions:

• Lattice dystrophy of the cornea can exhibit significant clinical variability, including late onset and late preservation of vision.
• Diagnostic acumen is crucial, as subtle corneal findings can be mistaken for other conditions like herpes simplex keratitis.
• Retroillumination may be essential for detecting fine lattice lines in atypical presentations.