Pragmatic approach in a case of unknown bilateral corneal opacity and staphyloma in a child in Timor Leste

Abstract

AbstractPurpose To demonstrate limited diagnostic and therapeutic options in ophthalmology in Timor Leste on the basis of a clinical picture of unknown corneal opacity.Methods Clinical‐pathological case report.Results A six year old girl was referred into the clinic because of a progressive corneal opacity in both eyes ‐ left more than right ‐ known since 18 life months. Clinically a light perception of the right eye could be observed. The left eye was amaurotic. A complete grayish‐ white opacification of both cornea which impeded any clinical examination of anterior and posterior segment were found.The surface of the left cornea was obviously bulged out, accordingly a proper lid closure was impossible. Further diagnostic testings like ultrasound, CT‐scanner, MRI or blood examination were not possible due to the limited resources. Assuming for a severe pathology and particulary a possible untraeted superinfection later on a evisceration was performed in general anaesthesia on the left eye. Histology done in Switzerland showed congenital corneal staphyloma with marked thickening of the cornea due to abnormal stromal connective tissue. Additionally, absence of Bowman and Descemet membranes as well as large anterior and focal posterior synechias of the iris were found.Conclusion The present pathologic findings were compatible with a very rare manifestation of Peters anomaly combined with abnormally thick intracorneal fibrosis and congenital corneal staphyloma. In the absence of any clinical supplementary examinations, a malignant intraocular tumour could be excluded histologically.