Lattice dystrophy
 

This is the most common stromal dystrophy seen in the examination. The other common ones being granular and macular dystrophy. There are refrctile, branching lines (sokmetimes with dots) int he stroma. The lines may have double contoured in advanced  cases. The periphery of the cornea is spared. In the examination: look for graft in the other eye. Of all the stromal dystrophy, lattice dystrophy has the highest tendency for recurrence  in the graft mention you like to look for systemic amyloidosis (rare) such as macroglossia and periorbital papules. .

Questions:

1. What types of lattice dystrophy do you know of?

Answer
Three types have been described.
Type 1, classic type, type AA amloid, no systemic amyloid deposition
Type II, lattice dystrophy with coexistent systemic amyloidosis, the lines are less numerous and located more peripherally. It is also known as Meretoja's syndrome. The patient may have cranial and peripheral neuropathy.
Tye III, mid-stromal and larger deposit than those in type I, the deposits are of type AP

2. The following is the histology of a patient with lattice dystrophy. What stain has been used?
  Answer
The cornea is stained with Congo red and contains multiple reddish deposits representing amyloid deposits.

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