Generalized posterior keratoconus: clinical pathologic correlations

CASE REPORT: A 73-year-old woman presented with bilateral generalized posterior keratoconus. The corneal thickness measured 0.320 mm paracentrally and 0.440 mm toward the periphery. The corneal specimen revealed absence of Bowman's layer and focal homogeneous oval stromal deposits that stained for amyloid. COMMENTS: Our case of generalized posterior keratoconus shows absence of Bowman's layer. The amyloid deposits, which also were noted clinically in the cornea of the fellow right eye, were most consistent with a diagnosis of polymorphous amyloid degeneration. To our knowledge, this is the first histopathological report of generalized posterior keratoconus.