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Clinical Diagnostic Dilemma between Reis Buckler and Thiel Behnke Corneal Dystrophy

Mousumi Banerjee, Aishwarya Rathod

Thiel Behnke corneal dystrophy (Corneal dystrophy of Bowman’s layer type II / honeycomb dystrophy)[1] is frequently confused with the hereditary epithelial stromal dystrophy Reis Bucklers. Although histopathological study and characteristic curly fibres on electron microscopy can lead to an unequivocal confirmation , there remains a clinical diagnostic dilemma between these two epithelial stromal dystrophy due to the similarities in symptoms , signs and genetic mutation. In this report , we present a case of biopsy proven Thiel Behnke dystrophy with recurrence in graft of right eye . In this case, we have tried to highlight the importance of extensive clinical examination including a proper clinical history along with the additional benefit of ASOCT and confocal microscopy as diagnostic tool to identify the subtle changes in the corneal anatomy which can help to reduce the diagnostic dilemma.