The Ophthalmology Unit,  Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.

The Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak, East Malaysia.

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Measles keratopathy

Photo by Professor Chua Chung Nen

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 choice.

 

Bilateral corneal scars.

 

The undilated pupil is hidden behind the corneal scar.

 

When the pupil was dilated, the fundus was found to be normal.

 

Post-iridectomy.

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