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JAMA Ophthalmology Clinical Challenge
October 2018

Shallowing of the Anterior Chamber During Optical Iridectomy for Peters Anomaly

Author Affiliations
  • 1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
JAMA Ophthalmol. 2018;136(10):1199-1200. doi:10.1001/jamaophthalmol.2018.0407

A 4-week-old male infant presented to the pediatric ophthalmology clinic with bilateral congenital corneal opacities. The pregnancy was full-term and uncomplicated, and he was delivered spontaneously without the use of forceps. His corneal abnormalities were noted by the neonatologists on the first day of life. A systemic survey revealed no other dysmorphic findings. He was referred to the clinic for further evaluation and management. Examination under anesthesia revealed bilateral corneal opacities with peripheral clearing and absent red reflexes. The white-to-white corneal diameters were 10 mm horizontally and vertically in both eyes, and B-scan ultrasonography revealed unremarkable posterior segments. Ultrasound biomicroscopy confirmed the diagnosis of Peters anomaly type I with iridocorneal adhesions and no apparent lens involvement. At the same session, a large iridectomy with lysis of iridocorneal adhesions was performed in both eyes to establish a clear, noncentral optical axis.

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