This case illustrate the importance of observing the patient before the slit-lamp examination. The differences in the corneal diameter may not be as apparent on the slit-lamp as it would be by naked eyes.
The affected eye has a larger corneal diameter. There are multiple horziontal lines in the Descemet's membrane (Haab's striae). The cornea may be oedematous if there are insufficient endothelium.
In the examination:
- look for secondary congenital glaucoma such as aniridia, anterior chamber cleavage syndrome
- mention tot he examiner that you like to measure the corneal diameter (the normal corneal diameter is between 10 and
12 mm) with the slit-lamp.
- check the cornea edge on the temporal side for any goniotomy scars. Also look for trabeculectomy scar at the superior
- examine the optic disc for glaucomatous changes
- check the patient's glasses, the affected side invariably has a myopic prescription.
1. What are the causes of congenital glaucoma.