Central cloudy dystrophy of François: a case series and literature review of a rare corneal disease

Central cloudy dystrophy of François (CCDF) is a rare corneal dystrophy characterized by bilateral, symmetric, gray, cloudlike lesions in the central posterior stroma. Diagnosis relies on detailed family history and careful slit-lamp examination to differentiate it from Vogt posterior crocodile shagreen. We describe 5 female siblings from two families (mean age, 58.5 years) with typical bilateral lesions consistent with CCDF. Very few cases of CCDF have been reported, and its pathophysiology and relationship to other corneal stromal dystrophies or degenerations remain poorly understood. These 5 cases constitute the second-largest series and the first documented reports of CCDF in the Mexican population, supported by representative illustrations and accompanied by a comprehensive literature review.