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1A. Right eye, direct illumination	2A. Left eye, direct illumination
1B. Right eye, direct illumination with arrows pointing to lesions	2B. Left eye, direct illumination with arrows pointing to lesions
1C. Right eye with retroillumination	2C. Left eye with retroillumination

Photo credits:  Sarah Moyer, CRA, OCT-C

A 65-year-old healthy Caucasian female presents for cataract evaluation. She notes increasing difficulty with glare, particularly at night, as well as increasing impairment of both distance and near vision. Past ocular history is remarkable only for hyperopic astigmatism. Family history documents no ocular disease. Best corrected visual acuity is 20/40 in both eyes. Cornea exam is displayed above. There are 3.5 nuclear sclerotic cataracts. The remainder of the examination is normal.

1.	In which layer are the identified corneal lesions present?
	a. epithelium b. Bowman’s layer c. stroma d. Descemet’s membrane e. endothelium
2.	Histologic evaluation of the above lesions with Congo red stain demonstrates focal deposits. These deposits are most likely:
	a. cholesterol b. complement c. lipid d. iron e. amyloid
3.	The diagnosis is:
	a. Fuchs dystrophy b. lattice dystrophy c. fleck dystrophy d. polymorphic amyloid degeneration e. Schnyder’s crystalline dystrophy
4.	Regarding prognosis, the patient should be counseled that this entity is:
	a. rapidly progressive, frequently requiring corneal transplantation b. post infectious and will likely resolve spontaneously c. bilateral, typically symmetric, and non-progressive d. associated with systemic hypertriglyceridemia e. associated with systemic amyloidosis
5.	Heritability of this entity is:
	a. autosomal dominant b. autosomal recessive c. sporadic d. X-linked recessive

For answers to the above, click here on or after June 5, 2012.