Week 11 Q&A

The triad of epiphora, blepharospasm, and photophobia with corneal clouding on exam is consistent with what pediatric ophthalmologic emergency?

Go to the profile of Andrew Moyer
May 15, 2018

A. Congenital nasolacrimal duct obstruction

B. Orbital cellulitis

C. Primary congenital glaucoma

D. Endemic keratoconjunctivitis

E. Congenital Horner syndrome

The correct answer is C. Primary congenital glaucoma. 

Primary Glaucoma
  • Primary infantile glaucoma (congenital glaucoma): 1:10,000–1:15,000; 90% sporadic

  • Caused by developmental defect in the structure of the anterior chamber

  • Associated systemic syndromes include Sturge–Weber, neurofibromatosis type 1, Marfan, Stickler, Lowe, Rubinstein–Taybi, Wolf–Hirschhorn

  • Also associated with ocular syndromes such as aniridia, Peters anomaly

Congenital glaucoma, right eye. Note that the right eye and cornea are much larger (buphthalmos) than the left.

Sources: (Question) Peterson AR, Wood KE. Pediatrics Examination and Board Review. New York, NY: McGraw-Hill Education; 2017

(Explanation) Shah SS et al. The Philadelphia Guide, 2nd ed. New York, NY: McGraw-Hill Education; 2016.

(Photo) Lueder GT. Pediatric Practice Ophthalmology. New York, NY: McGraw-Hill Education; 2011.

No comments yet.