Case report assisted and written by Kara Krautkramer from the School of Optometry at Indiana University. Presumed graduation date of May 2026.
26-year-old white male presents to our clinic for a contact lens follow-up. Slit-lamp examination revealed bilateral, symmetric, gray/white subepithelial opacities with a geographic pattern in the central cornea, sparing the periphery. The corneal epithelium appeared irregular with areas of superficial haze. History was remarkable for recurrent corneal erosions throughout childhood and adolescence. Family history also revealed a family history of a corneal disorder. Reis-Bücklers corneal dystrophy was diagnosed. This was confirmed by characteristic clinical findings and family history. This corneal dystrophy localizes to Bowman’s layer and generally has a good prognosis.
The patient was counseled on the hereditary nature of the disease and started on lubricating drops for symptom relief. Future management was referred for evaluation of possible phototherapeutic keratectomy (PTK) if erosions persist or visual function declines further. Follow-up was scheduled in three months. This case highlights the characteristic clinical presentation of Reis-Bücklers dystrophy and the importance of differentiating it from other anterior corneal dystrophies to guide appropriate management and genetic counseling, if the patient wishes.
