Granular Corneal Dystrophy Type 2 in a Middle-aged Male

The manuscript presents a 43-year-old male farmer who came to the Ophthalmology Outpatient Department (OPD) for his routine ophthalmological examination. No significant family history was elucidated. On clinical examination, his unaided Visual Acuity (VA) in right eye was 6/24, and that of left eye was 6/18. On slit lamp examination, the cornea showed diffuse, multiple, round to granular, breadcrumb-like opacities involving the sub-epithelium to the deep stroma (Table/Fig 1),(Table/Fig 2). Intraocular pressure was 18 mmHg in right eye and 15 mmHg in left eye. Nuclear sclerosis grade 2 with posterior sub-capsular cataract was seen in both eyes. Bilateral fundus examination did not reveal any abnormality. Immunohistochemical testing, light microscopy or genetic testing was not done as patient did not gave consent for the procedure. But the clinical picture of bread-crumb like opacities was highly suspicious of Granular Corneal Dystrophy (GCD) type 2. The patient was advised cataract extraction and underwent phacoemulsification with Posterior Chamber Intraocular Lens (PCIOL) implantation in right eye. The surgery was uneventful and post-operatively patient had an unaided VA of 6/9. Postoperative follow-up was of 15 days but the patient was lost to follow-up.