Corneal perforation with secondary congenital aphakia in Peters anomaly

Spontaneous bilateral corneal perforation in a neonate: A case report

Spontaneous corneal perforation is very rare in neonates and children. Peters anomaly is associated with spontaneous corneal perforation. Herein, we describe a case of spontaneous corneal perforation in a 13-day-old Saudi infant who was admitted to the neonatal intensive care unit since birth. This report is important to gain more information about corneal perforation clinical presentation in neonates, investigation, and management.

Spontaneous corneal perforation in an eye with Peters' anomaly

A premature female infant underwent her first ophthalmologic examination at the age of 4 weeks. The initial examination of the baby was requested for evaluation of a ‘white spot’ on the surface of her right eye. She had been hospitalized in the neonatal intensive care unit because of systemic abnormalities, such as a right clavicle fracture and microcephaly. Slit-lamp examination of the right eye showed a central corneal opacity, corneal thinning, and an iridocorneal adhesion. The lens and fundus of the right eye could not be observed. We observed no pathologic findings in the left eye. The baby’s parents were informed of the high risk for spontaneous corneal perforation without external pressure. At 42 days of age, an ophthalmologic examination of the infant was again requested for evaluation of ‘tears’ from her right eye 3 hours previously. Examination revealed corneal perforation, iris protrusion, and a fat anterior chamber. We performed emergent conjunctival flap surgery. Three months following surgery, the patient’s right eye was successfully preserved with no sign of inflammation or leakage.

A new approach to the classification of neonatal corneal opacities

PURPOSE OF REVIEW

Neonatal corneal opacification (NCO) describes the loss of corneal transparency at or soon after (<4 weeks) birth. Historically, the literature is strewn with terminology that has been at best misleading and at worst, a hindrance to selecting the appropriate treatment plan for, accurate genotype-phenotype correlation of and a better understanding of the entities that present in the clinic.

RECENT FINDINGS

Recent literature has demonstrated that certain terms such as 'sclerocornea' are unhelpful when alluding to total NCO. The term Peters anomaly has also become a 'waste paper basket' diagnosis for anterior segment developmental anomalies. A new classification of NCO is suggested by the author, which allows a better understanding of the cause of NCO and the likely prognosis of therapeutic intervention.

SUMMARY

This classification system should help the clinician understand the cause of NCO, better explain this to parents and recognize those conditions in which therapeutic intervention may be helpful. By understanding which conditions have a better chance of interventional success and by employing outcome definitions that take into consideration the developing neurobiological system of the infant brain and the effects of vision on its development, it is hoped more children with NCO will attain useful visual function.

Peters anomaly with post axial polydactyly, bilateral camptodactyly and club foot in a Kenyan neonate: a case report

Introduction

A case of bilateral Peters anomaly with bilateral post axial polydactyly, bilateral camptodactyly, and club foot was examined in a neonatal Kenyan baby girl of African descent who had been delivered in the hospital and admitted to the newborn unit. She died aged five days. There are no cases of Peters anomaly recorded in Africa according to a literature search. In addition, available data point to the majority of the principal associations in Peters anomaly to be genitourinary anomalies, making this case a rare one in its isolated collection of musculoskeletal associations.

Case presentation

A Kenyan baby girl of African descent who was born through a caesarean section presented in the new born unit of our hospital with bilateral corneal opacities, bilateral polydactyly, camptodactyly and club foot.

Conclusion

This is a rare case of Peters anomaly and its association with multiple musculoskeletal abnormalities makes it special.