An Unusual Presentation of Corneal Perforation in a Neonate Following Instrument-Assisted Delivery

Abstract

A 25-week-old neonate was noted to have unilateral corneal edema and buphthalmos at birth following a forceps assisted delivery. Ten days later, examination of the neonate under anesthesia showed a central corneal perforation with a possible retinal detachment. By this time the neonate’s affected eye was deemed unsalvageable, and therefore an enucleation was performed with insertion of an ocular implant. Subsequent histopathology of the enucleated eye revealed a grossly malformed anterior segment and findings usually associated with congenital glaucoma. This is the first reported case in the literature of a neonatal corneal perforation in the context of instrument-assisted delivery. This case highlights the need to actively investigate the aetiology of cloudy corneas in neonates. Early exploration and surgical intervention may be necessary especially if congenital glaucoma is suspected to be the underlying aeitlogy.