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ported by the finding of numerous lipid-laden keratocytes throughout the cornea and not necessarily adjacent to vessels, pointing to a primary disturbance of this cell popula t ion ra ther than a s imple inflammatory response. An ultrastructural study of a more conventional case of lipid keratopathy also demonstrated intracellular and extracellular lipid droplets and pyknotic keratocytes but revealed much fewer lipid-laden keratocytes. Although the precise nature and pathogenesis of the corneal disease in our patient remain speculation, our case together with other case reports previously published in the literature (under different names) strongly supports the concept of an independent disease process. Data to corroborate our theory would be the bilaterality, the lack of previous inflammatory episodes, the normal appearance of the conjunctiva, fairly normal blood lipids, and massive involvement of the whole cornea. Should simple neovascularization be the trigger of such a lipid keratopathy, one would expect to see many more patients with this problem. Perhaps one could, even under the aspect of its hypothetical nature, apply the name idiopathic lipid corneal dystrophy to such a disorder and thereby stimulate more publications of otherwise neglected cases where further molecular studies of the families might shed more light on this disease.

Giant Cell Angiofibroma of the Ocular Adnexae