Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 
  • Users Online: 1759
  • Home
  • Print this page
  • Email this page

   Table of Contents      
OPHTHALMIC IMAGE
Year : 2020  |  Volume : 68  |  Issue : 1  |  Page : 206

Butter like brittle cornea


Department of Cornea, Anand Eye Institute, Hyderabad, Telangana, India

Date of Web Publication19-Dec-2019

Correspondence Address:
Dr. Arjun Srirampur
Department of Cornea, Anand Eye Institute, Habsiguda, Hyderabad - 500 007, Telangana
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_520_19

Rights and Permissions

How to cite this article:
Katta KR, Srirampur A. Butter like brittle cornea. Indian J Ophthalmol 2020;68:206

How to cite this URL:
Katta KR, Srirampur A. Butter like brittle cornea. Indian J Ophthalmol [serial online] 2020 [cited 2020 Oct 29];68:206. Available from: https://www.ijo.in/text.asp?2020/68/1/206/273249



An 11-year-old girl presented with a corneal tear in her left eye (LE) of one day's duration, following a slap on her cheek by her brother while playing. There was no direct trauma to the eye. On examination, visual acuity in the right eye (RE) was 6/6 and that of LE was hand movements. Slit lamp examination of both eyes revealed a blue sclera and extreme corneal thinning from limbus to limbus without any obvious ectasia [Figure 1]a and [Figure 1]b, [Figure 2]b. The LE showed full thickness corneal tear [Figure 2]a. Topography of the RE showed a pachymetry of 350 μm without any ectasia [Figure 2]c. The child's parents gave a history of consanguineous marriage. The child suffered from hearing disability as well as small joint laxity. The clinical diagnosis was brittle cornea syndrome (BCS). The child underwent corneal tear repair under general anaesthesia. During suturing there was 'cheese wiring' of the cornea due to the needle track. Full thickness bites of the cornea were taken to prevent further tearing of the cornea. Cyanoacrylate tissue adhesive was used at the end to close the minor leaks. Suture knots were left unburied, as the very act of burying can lead to further extension of the tear and externally exposed knots induce more inflammation, leading to faster healing of the wound along with a quick taper of postoperative topical steroid drops. After 8 weeks the visual acuity improved to 20/80 with an well apposed wound [Figure 1]b.
Figure 1: (a) Diffuse slitlamp examination of left eye showing a large 10 mm irregular ‘J’ shaped corneal tear from limbus to limbus with iris prolapse and flat anterior chamber. (b) Postoperative diffuse slitlamp image showing sutured corneal tear with tissue adhesive

Click here to view
Figure 2: (a) Right eye showing bluish discoloration of the sclera. (b) Slit section of the right eye showing a thin cornea from limbus to limbus. (c) Topography of the right eye showing a thin pachymetry and normal keratometric values

Click here to view


BCS is a rare genetic, autosomal recessive, connective tissue disease with typical ocular, auditory, musculoskeletal, and cutaneous disorders.[1] The most common ophthalmic findings include keratoconus, progressive central corneal thinning, high myopia, irregular astigmatism, retinal detachment, and high risk for spontaneous corneal or scleral rupture.[2] Cornea in BCS is unable to withstand normal biomechanical stresses and hence cannot maintain their structural integrity and is susceptible to spontaneous corneal tear.[3]

In conclusion spontaneous corneal ruptures can happen in Brittle Cornea Syndrome. These eyes are at a life time risk of corneal tears even due to trivial injuries. Also, suturing the cornea is very challenging and can lead to further extension of the tear.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Zquierdo L Jr, Mannis MJ, Marsh PB, Yang SP, McCarthy JM. Bilateral spontaneous corneal rupture in brittle cornea syndrome: A case report. Cornea 1999;18:621-4.  Back to cited text no. 1
    
2.
Wan Q, Tang J, Han Y, Xiao Q, Deng Y. Brittle cornea syndrome: A case report and review of the literature. BMC Ophthalmol 2018;18:252.  Back to cited text no. 2
    
3.
Izquierdo L, Mannis MJ, Marsh PB, Yang SP, McCarthy JM. Bilateral spontaneous corneal rupture in brittle cornea syndrome: A case report. Cornea 1999;18:621-4.  Back to cited text no. 3
    


    Figures

  [Figure 1], [Figure 2]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
References
Article Figures

 Article Access Statistics
    Viewed341    
    Printed1    
    Emailed0    
    PDF Downloaded84    
    Comments [Add]    

Recommend this journal