Hereditary Epithelial Dystrophy of the Cornea.

IN 1963 our out-patients department was visited by a 27-year-old man with a corneal foreign body. On slit-lamp examination, both corneae appeared to be studded with numerous tiny, grey-white points, which were situated in the epithelium. In retrolight they appeared as fine, round, or somewhat irregular vesicles or droplets spread over the entire corneal surface, apart from the limbal area. Towards the periphery, the vesicles were somewhat larger and, at several points, islets of corneal epithelium had remained unaffected. Bowman's membrane, the parenchyma, Descemet's membrane, and the endothelium showed no alterations. The patient had never had eyecomplaints. In 1958, a brother of the propositus had been treated for a unilateral traumatical corneal erosion. A diagnosis had been made of the rare bilateral vesicular corneal affection which may be caused by dye-stuffs. This patient had done some painting in his home. The occurrence of an identical picture in these two brothers called to mind the hereditary epithelial dystrophy of the cornea first described by Pameijer (1935) and subsequently by Meesmann (1938), and to verify this diagnosis, a family investigation was carried out, in which 32 persons (16 men and 16 women) were examined. Five men and five women appeared to be affected by this rare hereditary corneal dystrophy (Figure.)