A 6-week-old infant has bilateral watering and photophobia present since birth, with blepharospasm. Both corneas are hazy and larger than normal for age, measuring 13 mm horizontally. Examination under anaesthesia confirms raised intraocular pressure. Which corneal finding, seen as curvilinear breaks in Descemet membrane, is characteristically produced by this disease?

• A Kayser-Fleischer rings
• B Vortex keratopathy
• C Posterior embryotoxon
• D Haab striae ✓

Explanation

The picture is primary congenital glaucoma: the classic symptom triad of epiphora, photophobia, and blepharospasm, with corneal oedema, corneal enlargement beyond 12 mm (buphthalmos), and raised pressure. Stretching of the cornea produces horizontal or circumferential breaks in Descemet membrane called Haab striae. Posterior embryotoxon is a prominent Schwalbe line seen in Axenfeld-Rieger anomaly, Kayser-Fleischer rings occur in Wilson disease around a normal-sized cornea, and vortex keratopathy reflects drug deposition, all unrelated to Descemet tears.

Reference: Khurana AK, Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.