Endothelial dystrophies produce characteristic morphological and functional abnormalities of the cornea. The most prevalent is Fuchs’ endothelial corneal dystrophy (FECD), which is characterized by bilateral primary cornea guttata and a reduced endothelial cell density that can result in corneal oedema, discomfort, and blurred vision. Histology shows a thickened Descemet’s membrane with focal posterior excrescences and endothelial cell loss. The onset of FECD is typically in the fifth decade of life,1 but an early-onset variant has been described that shows phenotypic differences from the more common late-onset disease.2 3 A genome-wide search of a three-generation family with early-onset FECD identified a locus on chromosome 1p34.3–p32.2 Within this locus a pathogenic mutation p.Q455K was found in the COL8A2 gene in this and two …