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Levi Watson
Levi Watson


The characteristic pathology associated with FCD is the appearance of small, non-progressive opacities within the stromal layer of the cornea. There are two distinct phenotypes of FCD opacities. However, these phenotypes are not mutually exclusive and can occur in the same family or the same patient. The first phenotype includes opacities that are small, oval, round, or semi-circular with well-defined margins, giving the cornea the "flecked" appearance for which the disease is named. The second phenotype of opacities resembles clouds or snowflakes with poorly defined borders. Although flecks are distributed throughout the stroma in both phenotypic cases, patients with the latter phenotype have opacities which are often most numerous in the posterior and central stroma. Areas of the stroma unaffected by the opacities appear grossly normal, and the endothelium, epithelium, Bowman's membrane, and Descemet's membrane are unaffected.[3]


A thorough slit-lamp examination of both eyes will demonstrate multiple fleck-like opacities in the corneal stroma. These opacities can be located throughout the cornea with intervening section of normal corneal tissue. Both corneas should demonstrate these opacities but may be different in distribution and concentration.

The fleck sign in the foot is a small bony fragment seen in the Lisfranc space (between the base of the 1st and 2nd metatarsal) associated with avulsion of the Lisfranc ligament (at the base of the 2nd metatarsal or the medial cuneiform). It is a very subtle, but important finding since it predisposes to Lisfranc injury. 041b061a72


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