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Clinical Features and In-vivo Confocal Microscopic Imaging of Fleck Corneal Dystrophy

ABSTRACT Purpose: To evaluate the value of in-vivo confocal microscopy (CM) in the diagnosis of Fleck corneal dystrophy. Methods: Case report and literature review. After complete eye examination of the patient, in-vivo CM was performed. The morphologies of the corneal layers were evaluated by in-vivo CM. Results: Slit-lamp examination revealed bilateral gray-white, oval or round discrete opacities in the stroma. Confocal microscopy showed hypereflective opacities in enlarged and unremarkable keratocyte nuclei throughout the stroma. The surface epithelium, subbasal nerves, and endothelium showed normal morphology. Conclusion: The diagnosis of rare corneal dystrophies such as Fleck corneal dystrophy should sometimes be made only after performing in-vivo confocal microscopy.