Corneal confocal microscopy anomalies associated with cowden syndrome: a case report.

[cowden syndrome]

To describe bilateral corneal alterations through confocal microscopy in a patient affected by Cowden syndrome (CS ).Evaluation of Schirmer 's , fluorescein , and lissamine green dye tests . Confocal microscopy was performed in both eyes to investigate corneal abnormalities .Slit lamp observation showed the focal involvement of anterior stromal and epithelial layers . Schirmer 's , fluorescein , and lissamine green dye test results were regular , while corneal confocal examination confirmed the disorganization of anterior stromal and epithelial layers in both eyes .CS is a rare autosomal-dominant systemic disorder . In our case , confocal analysis revealed predominance of alterations in the anterior stromal corneal layer , showing an increase of reflectivity , and a totally unstructured architecture in the epithelium layer . Even though the main purpose remains the prevention and the early diagnosis of different systemic tumors that could occur in affected patients , corneal confocal evaluation could play an important role in the early diagnosis of this rare disease .