Congenital hereditary endothelial dystrophy (CHED) Notes: Congenital hereditary endothelial dystrophy (CHED) is a rare genetic disorder affecting the corneal endothelium, leading to corneal clouding and visual impairment from birth or early childhood. CHED presents significant diagnostic and management challenges, especially in pediatric patients, due to its impact on visual development and quality of life. An 11-year-old boy presented with a history of bilateral blurred vision and photophobia since infancy. His parents reported no history of similar conditions in other members of the family. On examination, both corneas appeared diffusely thickened and cloudy. Slit-lamp biomicroscopy revealed diffuse stromal edema without epithelial bullae. Intraocular pressure was within normal limits. Corneal pachymetry showed increased corneal thickness bilaterally. Diagnostic Workup: Given the clinical presentation, a diagnosis of CHED was considered. The patient was managed conservatively with hypertonic saline drops to reduce corneal edema and photophobia.