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Year : 1976  |  Volume : 24  |  Issue : 2  |  Page : 19-20

A case of congenital corneal anaesthesia with dextro cardia and situs inversus with ASD

1 Department of Ophthalmology, Little Flower Hospital, Angamaly, Kerala, India
2 Department of Paediatrics, Little Flower Hospital, Angamaly, Kerala, India

Correspondence Address:
S Tony Fernandez
Department of Ophthalmology, Little Flower Hospital, Angamaly, Kerala
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Source of Support: None, Conflict of Interest: None

PMID: 72734

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How to cite this article:
Fernandez S T, Kuriakose M, Joseph M V. A case of congenital corneal anaesthesia with dextro cardia and situs inversus with ASD. Indian J Ophthalmol 1976;24:19-20

How to cite this URL:
Fernandez S T, Kuriakose M, Joseph M V. A case of congenital corneal anaesthesia with dextro cardia and situs inversus with ASD. Indian J Ophthalmol [serial online] 1976 [cited 2022 May 18];24:19-20. Available from: https://www.ijo.in/text.asp?1976/24/2/19/31528

Congenital corneal anaesthesia is a rare condition. A combination with dextro cardia and situs inversus has not been reported in the literature as far as we know.

  Case Report Top

A 4-year old girl was brought to the ophthalmic department with hypopyon ulcer in left eye. On exami­nation the corneal sensation was found to be absent in both eyes. Culture and sensitivity of the conjunctival discharge was taken. No organisms were cultured.

The ulcer was treated with mydriatics, local and systemic antibiotics. Subconjunctival injections of sof­ramycin were given without difficulty in the absence of surface anaesthesia. The ulcer did not show the expected improvement with the routine treatment. Hence lateral tarsorrhaphy was done after which the ulcer showed rapid improvement and healed completely with residual leucoma [Figure - 1].

While being an in-patient, the right eye also develop­ed a corneal ulcer. In view of the corneal anaesthesia and the condition of the left eye, lateral tarsorrhaphy was done in right eye also which helped in prompt healing of the ulcer.

On routine paediatric examination, it was found that the child was mentally normal and had dextro cardia. There was no clubbing of fingers. There was an ejection systolic murmur in second and third left intercostal spaces with fixed splitting of the pulmonary second sound. There was no other neurological deficit.

  Investigations Top

X-ray of chest showed dextro cardia with situs inversus [Figure - 2]. Electrocardiographically P1 is negative, PaVL is negative, PaVR and PaVF both are positive. There is no evidence of a supraventricular arrhythmia. Thus the electrocardiogram strongly sug­gested atrial inversion. Rr' pattern in V2 and V3R suggested an associated atrial septal defect.

  Discussion Top

Corneal anaesthesia has been described in Riley Day Syndrome as a part of the familial autonomic dysfunction with associated exces­sive sweating, drooling of saliva, intermittent hypertension and cyclic vomiting etc.[2] In our case such symptoms were absent. Corneal anaesthesia due to abnormality of cranial ner­ves was reported by Straub[3] as a possible cause of congenital corneal leucomata. Our patient developed corneal opacities only after the ulcer.

Lawford[1] described a case of bilateral (con­genital) corneal and conjunctival anaesthesia in a 6-year old child in 1907 which was diag­nosed because of an irregular ulcer in her left eye, but there was no mention of an associated dextro cardia.

  Summary Top

A case of bilateral congenital corneal ana­esthesia, associated with dextro cardia with situs inversus has been reported.

  Acknowledgement Top

Our thanks are due to Dr. C. K. Eapen, M. D., Medical Superintendent, for his permission to use the hospital records.

  References Top

Lawford, J.B., 1907, Trans. Ophthal. Soc., U. K., 21, 80.  Back to cited text no. 1
Riley Day, Grec'ey and Langford, 1949, Paediat­rics, 9, 468.  Back to cited text no. 2
Straubs Ophthalmologica 120, 401, 1950. [As quoted in Duke Elder (1964) System of Ophthal­mology, Part 11, Congenital Deformities, 514. Henry Kimpton.]  Back to cited text no. 3


  [Figure - 1], [Figure - 2]


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