A 4-month-old infant presents with bilateral cloudy corneas, photophobia, and excessive tearing since birth. On examination, the corneal diameter is 14 mm bilaterally and intraocular pressure is elevated. The most common cause of this presentation is:
- A Birth trauma (Descemet membrane tears)
- B Megalocornea
- C Congenital glaucoma (primary) ✓
- D Mucopolysaccharidosis
Correct answer: C. Congenital glaucoma (primary)
Explanation
The classic triad of congenital glaucoma includes epiphora (tearing), photophobia, and blepharospasm, along with corneal clouding and enlargement (buphthalmos). Corneal diameter >13 mm in an infant is abnormal. Primary congenital glaucoma results from abnormal anterior chamber angle development. Megalocornea has a large but clear cornea without elevated IOP. Birth trauma causes unilateral Haab striae. Mucopolysaccharidosis causes progressive clouding but is less common.
Reference: Pediatric Ophthalmology and Strabismus, AAO BCSC, 2023-2024 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.