This girl has Granular dystrophy type 1, which is an autosomal dominant condition affecting the TGFB1 gene. She had associated recurrent erosion of the corneal epithelium. Trans epithelial PTK was performed, ablating a combined 100 microns of tissue (approximately 50 microns of epithelium and 50 microns of stroma). Two months after the procedure, the left VA was 6/9 with no pain. Ablation to a depth that eliminates all of the lesions is not recommended as this removes too much tissue. Repeat ablation would be considered in the future, should the VA fall again and eventually an anterior lamellar transplant will probably be needed.