Lattice and granular corneal dystrophies

Lattice and granular corneal dystrophies are inherited conditions causing abnormal protein deposits to build up within the cornea, gradually clouding vision. They are named for the characteristic patterns these deposits create when viewed under a microscope.

Both are caused by inherited genetic mutations affecting proteins involved in corneal structure, most commonly the TGFBI gene, inherited in an autosomal dominant pattern. This means an affected parent has a 50% chance of passing the condition to each child.

Symptoms include gradually worsening blurred vision, glare and light sensitivity, and, in lattice dystrophy, recurrent painful corneal erosions where the surface layer breaks down. Symptoms typically progress slowly over years.

They don't threaten overall eye health beyond the cornea, but progressive clouding can significantly impair vision over time if untreated. Corneal transplant can effectively restore vision when deposits become visually significant.

Yes, both are inherited conditions, typically in an autosomal dominant pattern, meaning family members are at risk and genetic testing can confirm the diagnosis. Genetic counselling can help affected families understand inheritance risk.

There's no cure for the underlying genetic tendency to form deposits, but corneal transplant surgery can restore clear vision when deposits significantly affect sight, although deposits can sometimes recur in the new tissue over time. Regular monitoring helps track progression and timing of any intervention.

Mild cases may just need monitoring and treatment of any recurrent erosions with lubricating drops, while more advanced cases affecting vision are treated with corneal transplant surgery or, sometimes, laser treatment to remove superficial deposits. Your ophthalmologist will tailor management to your specific severity and symptoms.

Progression is typically gradual over years to decades, though the rate varies between individuals and even between family members with the same genetic mutation. Regular eye examinations help track any change in vision or corneal appearance.

Lattice dystrophy causes a distinctive branching line pattern of deposits and is more prone to painful recurrent corneal erosions, while granular dystrophy causes discrete crumb-like deposits and tends to cause fewer erosion episodes. Both are diagnosed by their characteristic appearance on eye examination.

Progressive blurring of vision, glare, or recurrent eye pain suggestive of corneal erosions should be assessed by an ophthalmologist. Private ophthalmology consultations can typically be arranged within about two weeks, considerably faster than standard NHS waiting times.