eMedicine Specialties > Ophthalmology > Cornea

Megalocornea: Differential Diagnoses & Workup

Author: Thomas A Oetting, MD, Professor, Residency Program Director, Department of Ophthalmology, University of Iowa Carver College of Medicine
Coauthor(s): Mark A Hendrix, MD, Consulting Staff, Department of Ophthalmology, Suburban Hospital, Shady Grove Hospital
Contributor Information and Disclosures

Updated: May 15, 2009

Differential Diagnoses

Glaucoma, Primary Congenital

Other Problems to Be Considered

Anterior megalophthalmos
Keratoglobus
High myopia

Workup

Other Tests

  • Gonioscopy  
    • Widened ciliary ring indicates anterior megalophthalmos.
    • Check for excessive mesenchymal tissue in the angle.
  • A-scan ultrasound biometry  
    • Buphthalmos may indicate congenital glaucoma.
    • Findings with megalocornea but not congenital glaucoma
      • Increased anterior chamber depth
      • Posterior lens-iris diaphragm position
      • Short vitreous length
  • Specular microscopy  
    • Normal endothelial cell density in megalocornea
    • Decreased endothelial cell density in congenital glaucoma

Histologic Findings

The cornea is histologically normal.

More on Megalocornea

Overview: Megalocornea
Differential Diagnoses & Workup: Megalocornea
Treatment & Medication: Megalocornea
Follow-up: Megalocornea
Multimedia: Megalocornea
References

References

  1. Saatci AO, Soylev M, Kavukcu S, Durak I, Saatci I, Memisoglu B. Bilateral megalocornea with unilateral lens subluxation. Ophthalmic Genet. Mar 1997;18(1):35-8. [Medline].

  2. Oetting TA, Newsom TH. Bilateral Artisan lens for aphakia and megalocornea: Long-term follow-up. J Cataract Refract Surg. Mar 2006;32(3):526-8. [Medline].

  3. Basti S, Koch DD. Secondary peripheral iris suture fixation of an acrylic IOL in megalocornea. J Cataract Refract Surg. Jan 2005;31(1):7; author reply 8. [Medline].

  4. Chang DF. Siepser slipknot for McCannel iris-suture fixation of subluxated intraocular lenses. J Cataract Refract Surg. Jun 2004;30(6):1170-6. [Medline].

  5. Kraft SP, Judisch GF, Grayson DM. Megalocornea: a clinical and echographic study of an autosomal dominant pedigree. J Pediatr Ophthalmol Strabismus. Sep-Oct 1984;21(5):190-3. [Medline].

  6. Mackey DA, Buttery RG, Wise GM, Denton MJ. Description of X-linked megalocornea with identification of the gene locus. Arch Ophthalmol. Jun 1991;109(6):829-33. [Medline].

  7. Maumenee IH. The cornea in connective tissue diseases. Ophthalmology. Oct 1978;85(10):1014-7. [Medline].

  8. Meire FM. Megalocornea. Clinical and genetic aspects. Doc Ophthalmol. 1994;87(1):1-121. [Medline].

  9. Meire FM, Bleeker-Wagemakers EM, Oehler M, Gal A, Delleman JW. X-linked megalocornea. Ocular findings and linkage analysis. Ophthalmic Paediatr Genet. Sep 1991;12(3):153-7. [Medline].

  10. Meire FM, Delleman JW. Biometry in X linked megalocornea: pathognomonic findings. Br J Ophthalmol. Oct 1994;78(10):781-5. [Medline].

  11. OMIM. Online Mendelian Inheritance in Man, OMIM(TM). McKusick-Nathans Institute for Genetic Medicine, Johns Hopkins University (Baltimore, MD) and National Center for Biotechnology Information, National Library of Medicine (Bethesda, MD), 2000. Available at: http://www.ncbi.nlm.gov/Omim/.

  12. Skuta GL, Sugar J, Ericson ES. Corneal endothelial cell measurements in megalocornea. Arch Ophthalmol. Jan 1983;101(1):51-3. [Medline].

  13. Srivastava AK, McMillan S, Jermak C, Shomaker M, Copeland-Yates SA, et al. Integrated STS/YAC physical, genetic, and transcript map of human Xq21.3 to q23/q24 (DXS1203-DXS1059). Genomics. Jun 1 1999;58(2):188-201. [Medline].

  14. Starck T, Hersh PS, Kenyon KR. Corneal dysgeneses, dystrophies, and degenerations. In: Principles and Practice of Ophthalmology. Vol 2. 2000:695-696.

  15. Wood WJ, Green WR, Marr WG. Megalocornea: A clinico-pathologic clinical case report. Md State Med J. Jul 1974;23(7):57-60. [Medline].

Further Reading

Keywords

enlarged cornea, corneal enlargement, anterior megalophthalmos, cataracts, glaucoma

Contributor Information and Disclosures

Author

Thomas A Oetting, MD, Professor, Residency Program Director, Department of Ophthalmology, University of Iowa Carver College of Medicine
Thomas A Oetting, MD is a member of the following medical societies: American Academy of Ophthalmology and American Society of Cataract and Refractive Surgery
Disclosure: Nothing to disclose.

Coauthor(s)

Mark A Hendrix, MD, Consulting Staff, Department of Ophthalmology, Suburban Hospital, Shady Grove Hospital
Mark A Hendrix, MD is a member of the following medical societies: American Academy of Ophthalmology and American Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Fernando H Murillo-Lopez, MD, Senior Surgeon, Unidad Privada de Oftalmologia CEMES
Fernando H Murillo-Lopez, MD is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

Christopher J Rapuano, MD, Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Co-Chairman of the Cornea Service, Co-Chairman of Refractive Surgery Department, Wills Eye Institute
Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Cornea Society, Eye Bank Association of America, International Society of Refractive Surgery, and Pan-American Association of Ophthalmology
Disclosure: Allergan Honoraria Speaking and teaching; Allergan Consulting fee Consulting; Alcon Honoraria Speaking and teaching; Inspire Honoraria Speaking and teaching; RPS Ownership interest Other; Vistakon Honoraria Speaking and teaching

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

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