Dystrophia Adiposa Corneae: An Out-of-the-Box Diagnosis

Dystrophia adiposa corneae is a degenerative corneal disorder characterised by fatty deposition, leading to corneal opacity and reduced visual acuity. We report a case of an Indian male in his early 40s with bilateral peripheral deep lipid deposition in the corneal stroma, beginning in an arcuate fashion and progressing to an annular-shaped structure. Furthermore, cholesterol crystals, as well as crystalline structures, were seen without any neovascularisation. We confirmed these findings on anterior segment optical coherence tomography (AS-OCT). We also noticed an increase in central corneal thickness (CCT), and on systemic workup, the patient was diagnosed with mild dyslipidaemia. This case highlights the need for an out-of-the-box diagnosis of a rare keratopathy, which can be vision-threatening and needs to be differentiated from its mimickers.