The pediatric ophthalmologist schedules an exam under anesthesia (EUA) that week.
The EUA findings are shown below:
External ocular exam:
Eyelids: flat OU, no ptosis OU
Conjunctiva: white and quiet OU
Cornea: OD Clear (10 mm), OS megalocornea (13 mm) with diffuse corneal edema and few Haab’s striae (horizontal break’s in Descemet’s membrane)
Anterior Chamber: OD deep and quiet, OS appears deep but hazy view of anterior chamber
Iris: OD flat, OS poor view
Lens: OD clear, OS poor view
Intraocular pressures (IOP) via rebound tonometer: OD 18 mmHg, OS 38 mmHg
Gonioscopy of both eyes demonstrates open angles (view in left eye limited by corneal edema). (see case 8 for more information on gonioscopy).
The optic nerve appearance in the right eye is shown on the right. The rest of the dilated eye exam is within normal limits in the right eye. There is no view to the back of the left eye. Therefore, B-scan ultrasound is performed which demonstrates a flat retina and no masses are present.
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Peds Ophtho Case 3 Index
Peds Ophtho Case 3: Introduction
Peds Ophtho Case 3: Additional History & Physical Exam