Beidseitige ringförmige stromale kristalline Hornhautablagerungen bei einem 8-jährigen Kind

An 8‑year-old boy was presented for assessment of stromal crystalline corneal opacity in both eyes with increasing photophobia. Slit-lamp microscopy revealed anterior stromal, crystalline, ring-shaped corneal deposits in both eyes, with otherwise unremarkable corneal findings. Based on these findings, the patient was diagnosed with a juvenile form of Schnyder corneal dystrophy. Annual follow-up was performed over a period of 3 years. The family history revealed a case of Schnyder corneal dystrophy in the patient's grandmother. In cases of atypical crystalline, annular corneal opacities in children, Schnyder corneal dystrophy should be considered in the differential diagnosis. It should be noted that crystalline deposits are present in only 50% of all patients with this corneal dystrophy. The diagnosis can be particularly challenging in young patients as typical clinical signs, such as discoid stromal corneal opacity or arcus lipoides corneae, often do not appear until the third decade of life and early findings of corneal dystrophies in childhood are rarely described in the literature. In the present case, the positive family history facilitated the diagnosis. Excimer laser-assisted phototherapeutic keratectomy was discussed as a potential treatment option but was not desired by the family.