An Infant With Enlarged Corneas
A 1-month-old boy was referred by his pediatrician for evaluation of large corneas of both eyes. The parents had noticed mild intransparency of the cornea at 2 days after birth, which resolved within a few days. On follow-up visit to the pediatrician, large corneas were noted and a referral for ophthalmology evaluation was made. The pediatrician did not notice any haziness of the corneas or other ocular abnormalities.
There was no history of photophobia or epiphora. The infant was systemically healthy with no significant medical or surgical history except for circumcision. There was no family history of childhood glaucoma.
Vision was considered normal for both eyes. The eyes were orthotropic by corneal light reflex testing (Hirschberg test). The pupils were equal, round, and briskly reactive, with no afferent pupillary defect. The ocular adnexa were normal bilaterally. Intraocular pressure (IOP) was 22 mm Hg in both eyes, measured by Tonopen with child asleep and the lids gently retracted by small muscle hooks. The corneas were approximately 12 mm horizontally and clear with no tears in Descemet's membrane visible by slit lamp. The anterior segment examination was otherwise unremarkable. The posterior segment examination was normal.
The most likely diagnosis is:
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<p>Megalocornea</p><br/><b>Discussion</b><br/><br/><p/>
A 1-month-old boy was referred by his pediatrician for evaluation of large corneas of both eyes. The parents had noticed mild intransparency of the cornea at 2 days after birth, which resolved within a few days. On follow-up visit to the pediatrician, large corneas were noted and a referral for ophthalmology evaluation was made. The pediatrician did not notice any haziness of the corneas or other ocular abnormalities.
There was no history of photophobia or epiphora. The infant was systemically healthy with no significant medical or surgical history except for circumcision. There was no family history of childhood glaucoma.
Vision was considered normal for both eyes. The eyes were orthotropic by corneal light reflex testing (Hirschberg test). The pupils were equal, round, and briskly reactive, with no afferent pupillary defect. The ocular adnexa were normal bilaterally. Intraocular pressure (IOP) was 22 mm Hg in both eyes, measured by Tonopen with child asleep and the lids gently retracted by small muscle hooks. The corneas were approximately 12 mm horizontally and clear with no tears in Descemet's membrane visible by slit lamp. The anterior segment examination was otherwise unremarkable. The posterior segment examination was normal.
The most likely diagnosis is:
Nasolacrimal duct obstruction
Congenital glaucoma
Megalocornea
Peter's anomaly
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<p>Megalocornea</p><br/><b>Discussion</b><br/><br/><p/>