Granular dystrophy

Granular dystrophy is another common stromal dystrophy. The features of granular dystrophy may differ from 
one family to another. Although classically described as having ' bread crumbs' appearance, some 
cases have crystalline like appearance (see above).

There are multiple small, well-dermacated, greyish white opacities in the anterior stroma (these can get progressively 
deeper with ageing). The intervening stroma is clear and the peripheral cornea is not involved.

Other possible signs:

  • the opposite eye either has similar changes or has corneal graft (if so examine the graft for any evidence of

  • recurrence). Clear zone on the graft may be the use of excimer laser to treat early recurrence.


1. What are the features of granular dystrophy?

2. The following is the histology of a patient with granular dystrophy. Which stain has been used?


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