Other corneal dystrophies

Crystalline dystrophy of Schynyder

Cloudy dystrophy of Francõis

Posterior polymorphous endothelial 

Map-finger-dot epithelial dystrophy

In the examination, the most common dystrophies you are likely to see are Reis-Buckler's, lattice, granular, 
macular and Fuch's endothelial dystrophies. As there are many different types of dystrophies, you may well be 
given less common types. Begin your presentation by describing which layer (epithelium, anterior or posterior 
stroma or endothelium) is involved, the pattern of the opacities (crystalline, vesicles, lines or circular etc), and 
if the opacities involves the centre or the periphery of the cornea.

Schynyder central crystalline dystrophy
There are multiple small white crystals in the centre of the cornea just below the Bowman's membranes. 
The surface of the cornea is uninvolved and there may be corneal arcus

Central cloudy dystrophy of Francõis
There are multiple greyish nebulous opacities separated by crack like clear zones (the changes may resemble 
crocodile shagreen). The opacities are denser in the centre and the posterior aspect of the cornea.

Posterior polymorphous dystrophy
There are multiple vesicles in the endothelium. There are also multiple greyish opacities which may be curvilinear 
or has scalloped edges. In some patients there may be stromal oedema or abnormal iris shape such as corectopia 
or iridocorneal adhesion (the changes may resemble ICE syndrome but the condition is bilateral)

Map-dot-fingerprint dystrophy (Cogan microcystic dystrophy)
Although a common epithelial dystrophy, it seldom appears in the examination. 
There are multiple opacities in the epithelium and has shapes resembling map lines, dots/microcysts or fingerprint 


1. How are the above dystrophies inherited?

2. How many different type of  endothelial dystrophies do you know of and how do they present?

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