Journal of Pediatric Ophthalmology and Strabismus

Images in Pediatric Ophthalmology 

Descemet's Membrane Breaks Following Forceps Delivery

David S Walton, MD

Abstract

Images courtesy of Mohammad Al-Amry, MD; and Arif O. Khan, MD

A 30-year-old woman desired refractive surgery in her right eye. She had a history of birth that required forceps delivery and poor vision in the right eye since childhood. The right eye had vertical Descemet's membrane breaks with areas of thickening in the central cornea and an uncorrected visual acuity of 20/300. The left eye had a normal cornea on slit-lamp examination and uncorrected visual acuity of 20/20. Cycloplegjc refraction was +2.75 -4.25 x 165 in the right eye (20/40) and +0.50-0.25 170 in the left eye (20/20).

Specular microscopy of the right eye revealed a low endothelial count (1,100/mm2) as well as endothelial cells of variable shape and size (polymorphism and polymegathism). Specular microscopy of the left eye (not shown) was unremarkable (cell count of 2,400/ mm2).

Readers are invited to submit their own interesting images from practice for publication. For submission requirements, please e-mail the Journal at JPOS@slackinc.com.

1. Lambert SR, Drack AV, Hutchinson AK. Longitudinal changes in the refractive errors of children with tears in Descemet's membrane following forceps injuries. JAAPOS 2004; 8: 368-370.

2. Honig MA, Barraquer J, Perry HD, Riquelme JL, Green WR. Forceps and vacuum injuries to the cornea: histopathologic features of twelve cases and review of the literature. Cornea 1996;15:463472.

3. Angeli LK, Robb RM, Berson FG. Visual prognosis in patients with ruptures in Descemet's membrane due to forceps injuries. Arch Opthalmol 1981;99:2137-2139.…

Images courtesy of Mohammad Al-Amry, MD; and Arif O. Khan, MD

A 30-year-old woman desired refractive surgery in her right eye. She had a history of birth that required forceps delivery and poor vision in the right eye since childhood. The right eye had vertical Descemet's membrane breaks with areas of thickening in the central cornea and an uncorrected visual acuity of 20/300. The left eye had a normal cornea on slit-lamp examination and uncorrected visual acuity of 20/20. Cycloplegjc refraction was +2.75 -4.25 x 165 in the right eye (20/40) and +0.50-0.25 170 in the left eye (20/20).

Specular microscopy of the right eye revealed a low endothelial count (1,100/mm2) as well as endothelial cells of variable shape and size (polymorphism and polymegathism). Specular microscopy of the left eye (not shown) was unremarkable (cell count of 2,400/ mm2).

Readers are invited to submit their own interesting images from practice for publication. For submission requirements, please e-mail the Journal at JPOS@slackinc.com.

REFERENCES

1. Lambert SR, Drack AV, Hutchinson AK. Longitudinal changes in the refractive errors of children with tears in Descemet's membrane following forceps injuries. JAAPOS 2004; 8: 368-370.

2. Honig MA, Barraquer J, Perry HD, Riquelme JL, Green WR. Forceps and vacuum injuries to the cornea: histopathologic features of twelve cases and review of the literature. Cornea 1996;15:463472.

3. Angeli LK, Robb RM, Berson FG. Visual prognosis in patients with ruptures in Descemet's membrane due to forceps injuries. Arch Opthalmol 1981;99:2137-2139.

10.3928/0191-3913-20070301-17

Sign up to receive

Journal E-contents