eMedicine Specialties > Ophthalmology > Cornea

Dystrophy, Granular: Follow-up

Author: William Trattler, MD, Miami Center for Excellence in Eye Care; Consulting Staff, Department of Ophthalmology, Miami Baptist Hospital
Coauthor(s): William Lloyd Clark, MD, Consulting Staff, Palmetto Retina; Natalie Afshari, MD, Assistant Professor, Cornea and Refractive Surgery, Department of Ophthalmology, Duke University Eye Center, Duke University Medical Center
Contributor Information and Disclosures

Updated: Mar 15, 2006

Follow-up

Further Outpatient Care

  • Patients with corneal epithelial defects from recurrent erosions need to be observed every few days to make certain the defect is healing.

Inpatient & Outpatient Medications

  • Patients with corneal epithelial defects from recurrent erosions require treatment with topical antibiotics to prevent infection.

Complications

  • Complications of granular corneal dystrophy include loss of vision and recurrent corneal erosions.
  • Complications of recurrent erosions include corneal infection and scarring, which can lead to significant decreased vision.

Prognosis

  • Prognosis is good, with symptomatic patients being eligible for either laser PTK or corneal transplant.

Miscellaneous

Special Concerns

  • A variant of granular dystrophy is called Avellino dystrophy. Its genetic defect also has been mapped to chromosome 5q.
    • In this condition, lattice deposits develop in the cornea years after typical granular deposits have developed. With age, deposits enlarge and form a corneal haze.
    • Symptoms are similar to granular dystrophy, with a slightly higher chance of pain and photophobia due to recurrent corneal erosions.
    • Management of Avellino dystrophy is similar to granular corneal dystrophy.
    • For excessive recurrent corneal erosions or decreased vision in eyes with predominantly superficial corneal opacities, excimer laser PTK can be performed.
    • For patients with vision loss after unsuccessful PTK, a corneal transplant can be performed. However, deposits eventually recur in the donor cornea.
  • Children of patients with granular corneal dystrophy should be monitored once they reach puberty, because this condition has an autosomal dominant inheritance pattern.
 


More on Dystrophy, Granular

Overview: Dystrophy, Granular
Differential Diagnoses & Workup: Dystrophy, Granular
Treatment & Medication: Dystrophy, Granular
Follow-up: Dystrophy, Granular
Multimedia: Dystrophy, Granular
References
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References

  1. Albert D, Jakobiec F. Principles and Practice of Ophthalmology. Vol 1. 1994:26-49.

  2. Das S, Langenbucher A, Seitz B. Excimer laser phototherapeutic keratectomy for granular and lattice corneal dystrophy: a comparative study. J Refract Surg. Nov-Dec 2005;21(6):727-31. [Medline].

  3. Grunauer-Kloevekorn C, Brautigam S, Wolter-Roessler M. Molecular genetic analysis of the BIGH3 gene in lattice type I (Biber-Haab-Dimmer) and granular type II (Avellino) corneal dystrophy: is indirect mutation analysis for hot spots recommended?. Klin Monatsbl Augenheilkd. Dec 2005;222(12):1017-23. [Medline].

  4. Klintworth GK. Advances in the molecular genetics of corneal dystrophies. Am J Ophthalmol. Dec 1999;128(6):747-54. [Medline].

  5. Krachmer J. Cornea. Vol 2. 1996.

  6. Yamamoto S, Okada M, Tsujikawa M, et al. The spectrum of beta ig-h3 gene mutations in Japanese patients with corneal dystrophy. Cornea. May 2000;19(3 Suppl):S21-3. [Medline].

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Further Reading

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Keywords

granular dystrophy, corneal dystrophy, granular corneal dystrophy

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Contributor Information and Disclosures

Author

William Trattler, MD, Miami Center for Excellence in Eye Care; Consulting Staff, Department of Ophthalmology, Miami Baptist Hospital
William Trattler, MD is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Coauthor(s)

William Lloyd Clark, MD, Consulting Staff, Palmetto Retina
William Lloyd Clark, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Natalie Afshari, MD, Assistant Professor, Cornea and Refractive Surgery, Department of Ophthalmology, Duke University Eye Center, Duke University Medical Center
Disclosure: Nothing to disclose.

Medical Editor

Fernando H Murillo-Lopez, MD, Senior Surgeon, Unidad Privada de Oftalmologia CEMES
Fernando H Murillo-Lopez, MD is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Christopher J Rapuano, MD, Professor, Department of Ophthalmology, Jefferson Medical College; Co-Chairman of the Cornea Service, Co-Chairman of Refractive Surgery Department, Wills Eye Hospital
Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Eye Bank Association of America, Pennsylvania Medical Society, and Philadelphia County Medical Society
Disclosure: Allergan Honoraria Speaking and teaching; Allergan Consulting fee Consulting; Alcon Honoraria Speaking and teaching; Inspire Honoraria Speaking and teaching; RPS Ownership interest Other

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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