Sudden Unilateral Corneal Clouding in an Infant
A healthy 3-month-old boy was brought to the emergency department because of the acute onset of corneal edema of the left eye (Panel A). One hour before presentation, his parents noticed that the left cornea was cloudy and the right eye was normal after he had been crying. While the patient was under anesthesia, evaluation revealed severe corneal edema of the left eye. The horizontal corneal diameter was 12 mm in the right eye and 13.5 mm in the left eye (reference range, 10 to 12). Intraocular pressure was 12 mm Hg in the right eye and 32 mm Hg in the left eye. Acute corneal hydrops with infantile glaucoma was diagnosed in the left eye. The boy underwent primary combined trabeculotomy and trabeculectomy in the left eye. Two weeks postoperatively, the left cornea showed dramatic improvement (Panel B). Six months postoperatively, an evaluation showed a clear cornea with Haab's striae (Panel C, arrows), which may affect vision if located centrally, and normal intraocular pressure (10 mm Hg in both eyes). At the last follow-up (2 years postoperatively), there was no corneal edema, the intraocular pressure was 12 mm Hg, and the visual acuity was 20/40 in both eyes.
