A newborn is noted to have epiphora, photophobia, blepharospasm, and cloudy enlarged corneas (diameter 13 mm) in both eyes. The most likely diagnosis is:
- A Megalocornea
- B Peter's anomaly
- C Primary congenital glaucoma (buphthalmos) ✓
- D Corneal clouding from congenital rubella
Correct answer: C. Primary congenital glaucoma (buphthalmos)
Explanation
Primary congenital glaucoma (buphthalmos) presents with the classic triad of epiphora, photophobia, and blepharospasm, along with corneal enlargement (>12 mm in a newborn) and Haab's striae (horizontal breaks in Descemet's membrane). The cause is trabeculodysgenesis—abnormal development of the trabecular meshwork and anterior chamber angle—impeding aqueous outflow. Megalocornea also has an enlarged cornea but without elevated IOP, photophobia, or tearing.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.