Question:
A patient presents with guttate lesions in one eye and bullous keratopathy in the other. What is the most likely diagnosis?
A patient presents with guttate lesions in one eye and bullous keratopathy in the other. What is the most likely diagnosis?
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Corneal guttata with bullous keratopathy = Fuchs' endothelial dystrophy.
Updated On: May 14, 2026
- Fuchs' endothelial dystrophy
- Viral corneal ulcer
- Interstitial keratitis
- Keratoconjunctivitis
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The Correct Option is A
Solution and Explanation
Concept:
Fuchs' endothelial dystrophy is a disease of corneal endothelium. It is characterized by corneal guttata and progressive endothelial failure, which may lead to corneal edema and bullous keratopathy.
Step 1: Identify the key finding.
The question mentions: \[ \text{Guttate lesions} \] These are corneal guttata, classically seen in Fuchs' endothelial dystrophy.
Step 2: Understand progression.
As endothelial cells fail, corneal hydration increases and causes: \[ \text{Corneal edema} \rightarrow \text{Bullous keratopathy} \]
Step 3: Select the diagnosis.
The combination of guttata and bullous keratopathy strongly indicates: \[ \text{Fuchs' endothelial dystrophy} \] Therefore, the correct answer is Fuchs' endothelial dystrophy.
Step 1: Identify the key finding.
The question mentions: \[ \text{Guttate lesions} \] These are corneal guttata, classically seen in Fuchs' endothelial dystrophy.
Step 2: Understand progression.
As endothelial cells fail, corneal hydration increases and causes: \[ \text{Corneal edema} \rightarrow \text{Bullous keratopathy} \]
Step 3: Select the diagnosis.
The combination of guttata and bullous keratopathy strongly indicates: \[ \text{Fuchs' endothelial dystrophy} \] Therefore, the correct answer is Fuchs' endothelial dystrophy.
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