The Ophthalmology Unit, Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.
The Ophthalmology Department, SarawakGeneralHospital,
Kuching, Sarawak, East Malaysia.
Photo by Professor Chua
This 55 year-old man
had had bilateral poor vision since the age of 5 following measles. The
vision was light perception in the right eye and 6/60 in the left eye.
There were anterior synechiae in both eyes with inferonasal corneal scar
indicating spontaneous healing of corneal perforations. The right pupil
could not be dilated but the left pupil dilated well with mydriatic.
Refraction of the left eye was -3.00/-3.00X180 but the vision could not
be improved beyond 6/60 most likely to be the result of deprivation
amblyopia. As the patient experienced a subjective improvement of vision
following pupil dilatation, a broad iridectomy was planned. Corneal
graft was also considered but because the corneal scar was thin and
involved the limbus, grafting is associated with a high risk of
rejection and therefore not carried out as the treatment of first
Bilateral corneal scars.
The undilated pupil is hidden
behind the corneal scar.
When the pupil was dilated, the
fundus was found to be normal.