Dr. (Mrs) Shobha G Pai, Dr. Rajesh Nayak, Dr. Madhurima K Nayak, Dr. Kalary Jayanthi
A 53 year old female, presented with a ten year history of gradually progressive diminution of vision, and glare worsened by bright sunlight, more in her right eye.Visual acuity was 6/60, with pinhole improving to 6/36 in the right eye and 6/36 improving to 6/18 in the left eye. Slit-lamp biomicroscopy revealed bilateral ring-shaped corneal opacities extending into the midperiphery but sparing the limbal zone suggestive of arcus lipoides; with paracentral circular haze in the right eye 3mm in diameter, spanning 4 to 6 clock hour positions.It was composed of a fine lacy garland of whitish crystals present primarily in the anterior stroma. A diagnosis of Schnyder corneal dystrophy was made.Physical examination demonstrated no xanthelasmas/genu valgum. Blood test showed total cholesterol 262 mg/dl and LDL 196 mg/dl.Physician reference was sought for management of her hypercholesterolemia.We advice evaluating all patients with Schnyder’s dystrophy for systemic hypercholesterolemia.