In primary congenital glaucoma, the classical triad of presentation includes all EXCEPT:

• A Epiphora (excessive tearing) and photophobia
• B Buphthalmos (enlarged globe due to high IOP in the compliant eye)
• C Haab's striae (breaks in Descemet's membrane causing corneal clouding)
• D Hypotony with macular folds ✓

Explanation

The classic triad of primary congenital glaucoma (PCG) is: (1) epiphora and photophobia due to corneal oedema and Descemet's membrane breaks (Haab's striae), (2) corneal haze/enlargement, and (3) buphthalmos (axial enlargement of the compliant infantile globe due to elevated IOP). Hypotony and macular folds are features of hypotony maculopathy (seen in over-filtration after glaucoma surgery), not PCG, which characteristically has elevated IOP.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.