This cloudiness, or opacity, usually appears in both eyes (bilaterally) in the upper cornea by 4 or 5 years of age.

These recurrent painful corneal epithelial erosions often begin as early as 1 year of age.

[1] With time, the corneal changes progress into opacities in Bowman's layer, which gradually becomes more irregular and more dense.

[1][2] The diagnosis of Reis-Bücklers corneal dystrophy is based on the clinical presentation, rather than labs or imaging.

A form of laser eye surgery named keratectomy may help with the superficial corneal scarring.