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.


1. What are the causes of congenital glaucoma.

2. What ocular conditions may be associated with buphthalmos.

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Right congenital glaucoma showing an increased right corneal diameter
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