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Ophthalmic Images

Corneal melt causing direct visualization of choroidal detachment

Bafna, Rahul Kumar; Sharma, Namrata; Mahalingam, Karthikeyan; Shaji, Kalathil Reshmi

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Indian Journal of Ophthalmology: October 2020 - Volume 68 - Issue 10 - p 2259
doi: 10.4103/ijo.IJO_1024_20
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A 65-year-old male presented with total corneal melt following graft infection. Intraocular contents were exposed [Fig. 1a], with direct visualization of the retina and inferior choroidal detachment [Fig. 1b]. There was history of therapeutic penetrating keratoplasty and vitrectomy done. We repeated penetrating keratoplasty to maintain globe integrity. Postoperatively [Fig. 1c] infection resolved and globe integrity was maintained after 6 months follow-up. Perforated corneal ulcer causes choroidal detachment and its frequency increases as the perforation size increases.[1]

Figure 1:
Clinical picture showing Corneal melt (a) with choroidal detachment (b). Post-operative clinical picture(c) at 6 months follow up

Some studies[2] recommend suprachoroidal drainage during keratoplasty. In our case as choroidal detachment was less severe, it resolved without drainage.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

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Conflicts of interest

There are no conflicts of interest.

1. Singh R, Umapathy T, Abedin A, Eatamadi H, Maharajan S, Dua HS. Choroidal detachment in perforated corneal ulcers: Frequency and management Br J Ophthalmol. 2006;90:1111–4
2. Maharajan VS, Dua HS, Maharajan P, Kuriakose T, Joseph A. Role of choroidal drainage in therapeutic keratoplasty Cornea. 2002;21:384–7
© 2020 Indian Journal of Ophthalmology | Published by Wolters Kluwer – Medknow