A Rare Case of Concurrent Granular Corneal Dystrophy and Keratoconus

A 23-year-old female presented with progressive bilateral visual loss for the past 5 years. The patient had no history of systemic disease, surgery or medications. Complete ophthalmologic examination and topography were performed. On ophthalmic examination, uncorrected visual acuity was 20/30 in the right eye and 20/50 in the left eye. Both corneas appeared hazy on gross examination. On slit-lamp biomicroscopy, few well circumscribed gray white discrete granular deposits in the central corneal stroma of both eyes were observed. Both corneas were thin and bulging. Corneal topography showed a pattern consistent with keratoconus. The patient was clinically diagnosed as a case of concurrent granular dystrophy and keratoconus, which is a very rare presentation.