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ORIGINAL ARTICLE
Year : 1984  |  Volume : 32  |  Issue : 4  |  Page : 229-230

Bilateral descemet's wrinkles in acute gastro-enteritis


TN Medical College & B.Y.L. Nair Hospital Mumbai, India

Correspondence Address:
Gyanam Murthy
Professor and head Ophthalmic unit. T.N. Medical College and B.Y.L. Nair Hospital Mumbai 400 008
India
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Source of Support: None, Conflict of Interest: None


PMID: 6571506

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How to cite this article:
Murthy G, Adrianwala S D. Bilateral descemet's wrinkles in acute gastro-enteritis. Indian J Ophthalmol 1984;32:229-30

How to cite this URL:
Murthy G, Adrianwala S D. Bilateral descemet's wrinkles in acute gastro-enteritis. Indian J Ophthalmol [serial online] 1984 [cited 2019 Oct 20];32:229-30. Available from: http://www.ijo.in/text.asp?1984/32/4/229/27395

Wrinkless and folds in the Descemet's membrane of cornea are constant features of ocular hypotony. Acute bilateral ocular hypotony maybe associated with a number of systemic diseases, particularly those involv­ing dehydration, acidosis and gross metabolic distrubances. Moreau et al[1], noticed ocular hypotony in extreme dehydration due to malnutrition. An interesting case of acute Gastro-enteritis with dehydration presented with sudden diminution of vision and bilateral Descement's wrinkles of cornea due to hypotony. Hypotony as the cause of these Descemet's wrinkles was confirmed by the disappearance of these wrinkles on correc­tion of dehydration and building up of the intra-ocular pressure to normalcy.


  Case report Top


A sixty years male, a case of acute gastro­enteritis with dehydration of four days dura­tion, presented with sudden- diminution of vision in both eyes. -There was no visual pro­blem prior to this attack.

On examiation, both eyes showed marked corneal haze with prominent double contour lines, in the absence of ciliary congestion. [Figure - 1][Figure - 2]. The eyeballs were soft indicating ocular hypotony. Visual acuity was C.F. 6

inches in both eyes. Due to corneal haze anterior segment and fundus details were not visualised. I.O.P. as recorded by Schiotz tonometer was 8.4 mm. Hg. in both the eyes. Slit lamp examination of both the eyes showed folds and wrinkles in Descemet's membrane. There was no aqueous flare and pupils were reacting briskly with early senile lenticular changes.

On correction of dehydration and control of gastro-enteritis, corneal folds disappeared [Figure - 3]. The intraocular pressure improved to 17.3 mm. Hg. in the right eye and 18.9 mm. Hg. in the left eye and visual acuity improved to 6/ 12 with + 1.5 spherical lens in right eye and to 6/9 .(F) with + 1.0 spherical/0.5 cylinder at 180°sub axis in the left eye.


  Discussion Top


Acute gastro-enteritis with dehydration is a systemic state of haemoconcentration lead­ing to increase in the osmotic pressure of the serum. This affects the ultrafiltration and sec­retion of the aqueous with lowering of the intraocular pressure. The resultant acute ocular hypotony manifests as rucked, saucer shaped hazy cornea, deeply grooved sclera and papilloedema, macular oedema, with generalised retinal oedema.

In our case the marked systemic dehydra­tion caused acute bilateral ocular hypotony with corneal changes alone in the form of Descement's wrinkles.

Ocular hypotony usually leaves behind residual changes in the eyes such as macular oedema, keratopathy and so on, with visual deterioration. The redeeming feature of our case was that, with the normal heamodyn­amics re-established with intravenous fluids, the Descemet's wrinkles disappeared and the intraocular pressure built-up to normalcy without any permanent visual derangement.


  Summary Top


An interest ing case of acute gastro-enteritis with temporary bilateral Descemet's wrinkles ofcornea due to hypotony showing reversal of these changes on correction of systemic dehydration is thus presented.

 
  References Top

1.
Moreau, Cornihert and Mugieret. 1963: Bull. Soc. Ophtal. Fr., 63:23.  Back to cited text no. 1
    


    Figures

  [Figure - 1], [Figure - 2], [Figure - 3]



 

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