Triad of benign fleck retina with keratoconus with myopia – A rare case report

Abstract

A 24-year-old male presented with a complaint of frequent change of glasses in both eyes. His best corrected visual acuity was 20/20 OD and 20/30 OS with a correction of − 6 DS/−3.75 DC @ 50° and − 4.5 DS/−3.25 DC @140°, respectively. Anterior-segment examination revealed a thin steep cornea with normal intraocular pressure in both eyes. Dilated fundus examination showed multiple yellow-white flecked lesions involving the entire fundus but sparing the fovea with pigmented lattices in both eyes. The flecks appeared as localized elevation at the RPE-Bruch’s membrane complex on optical coherence tomography. Corneal topography was suggestive of keratoconus. Examination of his family members did not reveal any abnormalities. Electroretinogram (ERG), electrooculogram, and color vision testing in both eyes were normal. The diagnosis of benign fleck retina with myopia with keratoconus was made. ERG helps distinguish benign familial fleck retina from other flecked retina syndromes to educate the patient about their visual prognosis. To the best of our knowledge, no such case has been reported in Indian literature till now.