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

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

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Spontaenous peripheral corneal perforation

Photo by Dr. Chieng Lee Ling and Professor Chua Chung Nen

A 37 year-old man presented with a sudden onset loss of right vision and red eye. Examination revealed peripheral corneal ulceration with perforation resulting in iris prolapse. The left cornea showed superior corneal infiltrates but without signs of corneal thinning. He had no systemic medical illnesses of note and denied any trauma. He was admitted to the ward and given regular topical ofloxacin, oral ciprofloxacin and oral doxycycline. The left eye was treated with topical steroid. An autoimmune screening was performed. The perforation was tamponaded using a bandage contact lens. After two days, the anterior chamber deepened spontaneously and the cornea became less cloudy. A tectonic graft was performed 7 days from the initial presentation.

 

Right superior peripheral corneal perforation with iris prolapse at presentation.

 

Improved corneal clarity and deepened anterior chamber following contact lens tamponade.

 

Tectonic graft.

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