Post-Traumatic Localized Post-Traumatic Localized Corneal Edema: Case Corneal Edema: Case

ReportReport

Tatiana C. Franco, MDTatiana C. Franco, MDNathalie M. Guibord, MDNathalie M. Guibord, MD

Geisinger Medical CenterGeisinger Medical CenterAuthors have no financial interestAuthors have no financial interest

Purpose/Objective:Purpose/Objective:

To report a case of post-traumatic To report a case of post-traumatic localized corneal edema due to an localized corneal edema due to an inadvertent foreign body in the inadvertent foreign body in the anterior chamber. anterior chamber.

Materials/Methods:Materials/Methods:

Case Report Case Report

HistoryHistory

A 43-year-old man A 43-year-old man Went to ER complaining of blurriness, Went to ER complaining of blurriness,

pain and photophobia 1 day after a pain and photophobia 1 day after a rock hit his left eye. rock hit his left eye.

Treated as corneal abrasion by the Treated as corneal abrasion by the ER staffER staff

HistoryHistory

2 months later: no improvement2 months later: no improvement– Referred to ophthalmologyReferred to ophthalmology

Eye exam: mild iritis and central Eye exam: mild iritis and central corneal scar. corneal scar.

Treated with topical prednisoloneTreated with topical prednisolone Symptoms improved and Symptoms improved and

inflammation resolvedinflammation resolved

HistoryHistory

Patient returned 20 months post-injury complaining Patient returned 20 months post-injury complaining

of blurry vision, red and painful eyeof blurry vision, red and painful eye

Worsened VAWorsened VA:: from 20/25 to 20/60 in the injured from 20/25 to 20/60 in the injured

eyeeye

Iritis (mild)Iritis (mild)

Inferior corneal edema surrounding old scarInferior corneal edema surrounding old scar

Pachymetry (microns):Pachymetry (microns):

– central 639 , paracentral 950 and peripheral 983central 639 , paracentral 950 and peripheral 983

Figure 1. Presentation 20 months post injury showingcorneal scar with localized inferior edema.

Figure 2Figure 2. Gonioscopy showing foreign body . Gonioscopy showing foreign body

at 6 o'clock position.at 6 o'clock position.

ManagementManagement

anterior chamber washout anterior chamber washout

Figure 3. Resolution of corneal edema

Pre-operative Post-operative

Post-AC Washout Endothelial Post-AC Washout Endothelial Cell Count and PachymetryCell Count and Pachymetry

Cell countCell count PachymetrPachymetr

yy– Central: Central:

607607

ConclusionConclusion

This case shows that gonioscopy is This case shows that gonioscopy is highly valuable in the thorough highly valuable in the thorough evaluation of certain eye injuriesevaluation of certain eye injuries– Especially in those cases where a Especially in those cases where a

foreign body is suspected. foreign body is suspected.