Bilateral Keratoconus With Bilateral Fuch's Dystrophy In Identical Twins- A Rare Case Scenario

To report a rare case of bilateral keratoconus with bilateral Fuch's dystrophy in identical twins

case report

Two identical twins presented to our clinic with a diminution of vision in both eyes for few months. Both patients had an astigmatic refractive error in both eyes. On slit lamp examination corneal endothelium showed multiple guttate in both eyes of twins. A pentacam scan was done and it confirmed the diagnosis of keratoconus in both eyes of twins. Both cases underwent corneal collagen cross-linking in both eyes. There was mild haze in the postoperative period which cleared off on 1-month follow-up. The past literature has given an association between Fuch's dystrophy and keratoconus but this was a very rare case as it presented in both eyes of identical twins.

Always screen the family members of dystrophy and keratoconus patients. It is very important to get topographical scans in young patients presenting with corneal endothelial guttate, to rule out ectatic disorders. The corneal collages crosslinking is a safe procedure in patients of corneal ectasia with endothelial dystrophy.