Buphthalmos
 

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 limbus examine the optic disc for glaucomatous changes check the patient's glasses, the affected side invariably has a myopic prescription.

Questions:

1. What are the causes of congenital glaucoma.

Answer
primary congenital glaucoma
anterior cleave syndrome such as Axenfeld, Reiger and Peter's syndrome
rubella
phakomatosis such as Sturge-Weber's syndrome and neurofibromatosis
aniridia
persistent hyperplastic primary vitreous

2. What ocular conditions may be associated with buphthalmos.

Answer
Myopia
Lens subluxation
Corneal decompensation
Retinal detachment

Return to the main page
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Right congenital glaucoma showing an increased right corneal diameter Return to the top