Week 11 Q&A
The triad of epiphora, blepharospasm, and photophobia with corneal clouding on exam is consistent with what pediatric ophthalmologic emergency?
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.
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