A cytologic aid in the diagnosis of congenital glaucoma

The superficial corneal epithelium of 17 patients with glaucoma varying in age from nine days to 16 years and 25 normal individuals varying from nine months to 16 years were studied comparing findings using the Giemsa and Papanicolaou staining methods. The normal individuals exhibited a high frequency of precornified cells and a paucity of cornified cells with pyknotic nuclei. Smears of 16 of the 17 patients with glaucoma stained by the Papanicolaou method illustrated striking tinctorial changes. In a 9-day-old patient with glaucoma there were occasional normal cells, but many others varied greatly both in shape and size. In addition, highly cornified, deep orange, Papanicolaou stained cells with pyknotic nuclei were noted. These changes were so pronounced that examination of a single section strongly suggested a diagnosis of glaucoma. Cells in the older patients (6 to 16 years) frequntly exhibited a high degree of cornification, extensive cell fragmentation, darkly stained pyknotic nuclei, and areas of ghost cells. The cytologic characteristics of stained corneal epithelium cells were a demonstrable aid in the early diagnosis of glaucoma.