Atlas of Ophthalmology

Unilateral Oblique Descemet Membrane Breaks after Forceps Delivery (Colour Photography Anterior Segment, Optical Coherence Tomography Heidelberg E)

Córnea -> Trauma
Patient: 15 years of age, female, visual acuity 20/80, IOP 16/14 mmHg Ocular Medical History: significantly decreased visual acuity at OS, regular optic nerve head. General Medical History: empty Main Complaint: decreased vision at OS. Purpose: to show unilateral descemet membrane breaks without any sign of glaucoma. Methods: Colour Photography Anterior Segment, Optical Coherence Tomography Heidelberg E Findings: Colour Photography Anterior Segment: unilateral descemet membrane (DM) ruptures secondary to forceps delivery, oblique oriented. Optical Coherence Tomography: regular retinal nerve fiber thickness. Discussion: Ganesh et al (1) commented that forceps injury to eye usually occurs as a result of compression of the globe between the orbital roof and the blade of the obstetric forceps. The descemet membrane breaks can cause refractive errors. A normal intraocular pressure facilitates differentiation from congenital glaucoma. The residual single or multiple descemet membrane breaks appear as vertical or oblique median striae. These corneal lesions are primarily unilateral and may cause amblyopia. Literature: (1) Ganesh S, Arora P, Arora K. Descemet membrane breaks following forceps delivery. Indian Pediatr. 2013 Feb;50(2):257

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