Optical coherence tomography and in vivo confocal microscopy features of obstetric injury of the cornea.

We present a case of a 54-year-old man who reported to our department complaining of worsening vision and halos in the left eye. Slit-lamp biomicroscopy showed 2 distinctive oblique vertical lines situated on the posterior surface of the cornea. Anterior segment optical coherence tomography (AS-OCT) demonstrated bandlike structures protruding from the cornea into the anterior chamber for approximately 430 and 100 microm. In vivo confocal microscopy (IVCM) revealed stromal edema, low endothelial density, and prominent hyperreflective linear structures at the endothelium depth and behind the endothelium. The patient had a history of complicated, in-hospital, forceps-assisted delivery. The perinatal ophthalmic history was noncontributory. The fellow eye was healthy. We conclude that AS-OCT and IVCM are useful in confirming the clinical diagnosis of suspected perinatal corneal trauma because of the specific appearance of the Descemet membrane hypertrophic ridge in those examinations. There is a good correlation between the results of AS-OCT and IVCM.