Secondary, vocational crystalline keratopathy – case report

Purpose To present case of secondary, vocational crystalline keratopathy in patient with history of long‐time exposure to glass wool. Methods The patient was consulted in Ophthalmology Outpatient Clinic because of suspicion of crystalline keratopathy of unknown origin. The following tests were performed: basic slit lamp examination, corneal scans using OCT Visante (Zeiss, Germany) and corneal confocal microscopy in vivo (Rostock Cornea Module, Heidelberg Engineering Retina tomograph III). Results On a slit lamp examination we described macroscopic crystal deposits within epithelial layer. In the images from the OCT Visante ‐ hiperreflective deposits obscuring other structures of the cornea were present only in epithelial and subepithelial layers. Crystals were not crossing Bowman membrane border. The corneal confocal microscopy images described monomorphic needle‐like crystals without arborations, covered by epithelial cells and infiltrating epithelial layer, epithelial basal membrane and Bowman membrane. Anterior and posterior stroma presented no abnormalities. On anamnesis patient reported history of 25 years of occupational exposure to glass wool. Additionally we excluded other possible causes of crystalline keratopathy, such as hypercholesterolemia, hiperuricemia, cystinosis and hematopoietic disorders. Conclusion Corneal confocal microscopy is a useful tool for the detection and differentiation of corneal keratopathies of uncertain etiology.