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.

Questions:

1. What are the features of granular dystrophy?

Answer
It is an autosomal dominant condition. It usually presents in the teens with photophobia or abnormal corneal appearance. Unlike lattice dystrophy, recurrent erosion is uncommon. Vision is often normal or only become impaired in the 40s. Full thickness graft is sometimes needed but recurrence is unusual.

2. The following is the histology of a patient with granular dystrophy. Which stain has been used?
  Answer
The cornea has been stained with Masson trichrome which shows up the
granular dystrophy as red.
 

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