eMedicine Specialties > Ophthalmology > Genetic Disorders

Peters Anomaly: Follow-up

Author: Guruswami Arunagiri, MD, FRCS, Department of Ophthalmology, Permanente Medical Group, Sacramento, CA
Contributor Information and Disclosures

Updated: Feb 20, 2009

Follow-up

Further Outpatient Care

  • An ophthalmologist should provide regular follow-up care for patients with graft rejection and glaucoma.
  • A pediatrician should monitor patients for other congenital anomalies.
  • Patients should receive visual rehabilitation as needed.
  • A pediatric contact lens specialist should fit patients with aphakic contact lenses.

Inpatient & Outpatient Medications

  • Medications may be indicated for glaucoma and postgraft treatment.

Complications

  • Complications include amblyopia and decreased vision or blindness from glaucoma.
  • Complications of corneal transplantation and cataract surgery are numerous.

Prognosis

  • The visual prognosis is guarded. The earlier the keratoplasty is performed, the better the chances of preventing deprivation amblyopia. The visual acuity in patients after keratoplasty was 20/80 or worse in most series; some series reported a visual acuity of 20/40 in patients. Also, in most series, the chances that patients maintain a clear graft were 30-50% at 10 years. Patients with glaucoma and cataract had a worse prognosis.
  • The prognosis for life depends on other systemic anomalies.

Patient Education

  • Children with Peters anomaly require special educational needs depending on the visual outcome. A low-vision specialist should evaluate these children. Patients may need loupes and binoculars depending on the visual potential.

Miscellaneous

Medicolegal Pitfalls

  • Failure to recognize Peters anomaly from other conditions that mimic it
  • Failure to refer to other specialists to rule out systemic anomalies
  • Failure to provide regular follow-up care for those children with graft rejection or glaucoma
  • Failure to offer visual rehabilitation

Special Concerns

  • Cases of Peters anomaly have been reported to occur with fetal alcohol syndrome. Drinking during pregnancy should be discouraged.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the assistance of Ryan I Huffman, MD, with the literature review and referencing for this article.



More on Peters Anomaly

Overview: Peters Anomaly
Differential Diagnoses & Workup: Peters Anomaly
Treatment & Medication: Peters Anomaly
Follow-up: Peters Anomaly
References
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References

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Further Reading

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Keywords

Peter's anomaly, Peters anomaly, keratolenticular dysgenesis, congenital central corneal leukoma, dysgenesis mesodermalis of the cornea, anterior segment dysgenesis

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Contributor Information and Disclosures

Author

Guruswami Arunagiri, MD, FRCS, Department of Ophthalmology, Permanente Medical Group, Sacramento, CA
Guruswami Arunagiri, MD, FRCS is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Medical Editor

Brian A Phillpotts, MD, Former Vitreo-Retinal Service Director, Former Program Director, Clinical Assistant Professor, Department of Ophthalmology, Howard University College of Medicine
Brian A Phillpotts, MD is a member of the following medical societies: American Academy of Ophthalmology, American Diabetes Association, American Medical Association, and National Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

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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