The condition under consideration may be defined as a deep interstitial fat and cellular infiltration of the cornea (usually vascular) and part of a disturbance in fat metabolism. The process is usually protracted, painless and bilateral, though a long interval may separate involvement of the second eye.
EARLY, ACTIVE LESION
The deep central area of the cornea or its margin may be affected first. Careful biomicroscopic methods usually show a deep peripheral feed in the central lesions. The earliest changes consist of fine droplets, varying in size, and cells infiltrating the substantia propria, associated with loss of transparency anterior to Descemet's membrane, and associated with endothelial pitting. A deep vascular loop composed of an entering small artery and a larger returning vein pushes in, preceded by an arc of loss of transparency. Adjacent to the loop may be seen the minute droplets. The cell stream in the early and