Unilateral Idiopathic Lipid Crystalline Keratopathy: A Rare Case Report

Purpose: To report a case of unilateral idiopathic lipid crystalline keratopathy involving adjacent limbus. Methods: A 54-years-old female referred to Cornea clinic because of gradually decreased visual acuity since 10 years ago. On ocular examination, a mostly inferotemporal located, 8 by 7 cm, whitish corneal mass was seen on left eye without any vascularization. History of systemic lipoprotein disorders or lipid dystrophies of cornea was negative. Confocal scan and finally histopathologic exam confirmed the diagnosis. The fellow eye ocular exam was completely normal with distant BCVA of 10/10. Results: Due to visual axis involvement and decreased vision, the patient undergone penetrating keratoplasty. There was no recurrence of disorder within six-months follow-up. Conclusion: In cases of corneal lipid deposition, serum lipids level should be evaluated and ocular disorders cause secondary lipid keratopathy should be considered. Unilateral primary lipid keratopathy is extremely rare, but should be contemplated as a diagnosis of exclusion.