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Visual prognosis in patients with ruptures in Descemet's membrane due to forceps injuries
Insights
Forceps injury at birth can cause Descemet's membrane ruptures, leading to high astigmatism and severe amblyopia. These eye injuries may also result in axial myopia, potentially linked to early postnatal eye occlusion.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Corneal Surgery
Background:
- Descemet's membrane ruptures can occur due to birth trauma, specifically forceps injury.
- These ruptures may lead to significant visual impairments in newborns.
Observation:
- Seven patients with forceps-induced Descemet's membrane ruptures were examined.
- Ophthalmological examinations revealed vertically oriented breaks, high corneal astigmatism, deep amblyopia, and axial myopia in all patients.
- Ultrasound measurements in two patients indicated elongated axial lengths.
Findings:
- Forceps injury at birth is associated with Descemet's membrane ruptures.
- These ruptures correlate with high astigmatism, deep amblyopia, and axial myopia.
- Elongated axial lengths were observed in some affected eyes.
Implications:
- The findings suggest a link between Descemet's membrane ruptures from birth trauma and subsequent visual deficits.
- Axial myopia and amblyopia may be influenced by partial occlusion of the affected eye in early life.
- This study highlights the potential for visually induced myopia following neonatal eye injury.
Abstract:
Seven patients with Descemet's membrane ruptures associated with a forceps injury to the eye at birth were studied. A complete ophthalmological examination was done on each patient, and two patients had ultrasound measurements of the axial lengths of both eyes. We found that the ruptures in Descemet's membrane were single or multiple vertically oriented breaks associated with high astigmatism along the axis of the breaks and deep amblyopia in all patients. The astigmatic errors were corneal in origin. High myopia was also present in the involved eye and was thought to be axial in all patients. Two patients did have elongated axial lengths demonstrated by ultrasonography. The presence of axial myopia and deep amblyopia may relate to partial occlusion of the involved eye during the early postnatal months. The latter possibility is discussed in light of recent reports of myopia induced by early postnatal occlusion in animals.