Purpose: To evaluate the value of in-vivo confocal microscopy (CM) in the diagnosis of Fleck corneal dystrophy.
Methods: Case report and literature review. After complete eye examination of the patient, in-vivo CM was performed. The morphologies of the corneal layers were evaluated by in-vivo CM.
Results: Slit-lamp examination revealed bilateral gray-white, oval or round discrete opacities in the stroma. Confocal microscopy showed hyper-reflective opacities in enlarged and unremarkable keratocyte nuclei throughout the stroma. The surface epithelium, subbasal nerves, and endothelium showed normal morphology.
Conclusion: The diagnosis of rare corneal dystrophies such as Fleck corneal dystrophy should sometimes be made only after performing in-vivo confocal microscopy.