Bilateral Dense Peripheral Corneal Clouding Like Fish Eye Syndrome (Fed) In Healthy Female Patient

To describe a case of 56 years old patient with bilateral severe peripheral corneal opacity, no systemic finding of interest

Santa Lucia Ophthalmological Hospital,  Buenos Aires City,  Argentina

A 56 years old female patient was admitted to the emergency room complaining of ocular symptoms, as stinging, burning and blurred vision. The patient had no history of systemic disease.

Slit-lamp examination showed bilateral dense peripheral corneal clouding, preserving transparency in the central 3.5mm of cornea, allowing a best corrected visual acuity of 20/25 in the right eye and 20/50 in the left eye. Break up time was decreased, no keratitis or conjunctival inflammation was detected. Nuclear cataract 2X in right eye and 3X in left eye. The IOP was 14mmHG in both eyes. Funduscopy, optic nerve and macula examination showed no abnormal findings. Treatment with artificial tears was started with improvement of dry eye symptoms.

Blood test and LDL, HDL and TAG requested showed normal results. No hepatic, renal, cardiac or other systemic alterations were found.

Genetic studies in process to find recessive genetic disease or any rare enzyme alteration.

Enzyme lipid disorder (like Fish eye disease, FED) and mucopolisacaridosis are rare genetic syndromes that occur with dense peripheral corneal opacity associating with systemics, comorbidities alterations and specific biochemical characteristics.

Up to now, no systemic alterations of interest were found in our patient, which makes it an extremely rare case in literature.