TITLE:
An Unusual Presentation of Corneal Perforation in a Neonate Following Instrument-Assisted Delivery
AUTHORS:
Christolyn Raj, John Ruddle, Alice Downey
KEYWORDS:
Corneal Perforation, Congenital Glaucoma, Birth Trauma, Enucleation
JOURNAL NAME:
Surgical Science,
Vol.5 No.8,
August
6,
2014
ABSTRACT: A 25-week-old neonate was noted to
have unilateral corneal edema and buphthalmos at birth following a forceps
assisted delivery. Ten days later, examination of the neonate under anesthesia
showed a central corneal perforation with a possible retinal detachment. By
this time the neonate’s affected eye was deemed unsalvageable, and therefore an
enucleation was performed with insertion of an ocular implant. Subsequent
histopathology of the enucleated eye revealed a grossly malformed anterior
segment and findings usually associated with congenital glaucoma. This is the
first reported case in the literature of a neonatal corneal perforation in the
context of instrument-assisted delivery. This case highlights the need to
actively investigate the aetiology of cloudy corneas in neonates. Early
exploration and surgical intervention may be necessary especially if congenital
glaucoma is suspected to be the underlying aeitlogy.