Photodtlus

Central Cornea1 Dystrophy of Francois

Joe B. Goldberg, OD, FAA0

The central cornea1 dystrophy of Francois’ is a cornea1 change that may be rarely observed in practice. It is a cloud of vaguely defined opacities that resemble snowflakes with- out definite structure or limits that is restricted to the pu- pillary area (see Figure I). The cornea1 periphery is clear.

The dystrophic area is in the deeper layers of the stroma. However, Bowman’s layer, Descemet’s membrane, and the endothelium remain intact. There is very little progression or inflammation and no symptoms.

This rare cornea1 condition was observed with biomicros- copy using direct illumination, broad and medium beams, and low and high magnification. The patient is a 58-year- old Caucasian female who wears rigid gas permeable as- pheric progressive add multifocal cornea1 lenses successfully for daily wear. There is no interference with far or near vision and the patient wears the lenses during all of her waking hours.

Address reprint requests to Dr. Joe B. Goldberg, 4217 Virginia Beach Blvd., Virginia Beach, VA 23452.

Accepted for publication July 17, 1992.

Figure 1. A group of gray-white opacities in the pupillary area are observed under a direct illumination, medium beam. They have varied sizes and shapes and are scattered throughout the pupillary area.

Reference

1. Duke-Elder S: Cornea1 degenerations, dystrophies and pig- mentations, in Duke-Elder S (Ed): System of Ophthalmology. St. Louis, MO, C.V. Mosby, 1965, chap VII, pp 947-948.

44 ICLC, Vol. 20, January/February 1993 0 1993 Butterworth-Heinemann