Diagnostic Considerations

Posterior keratoconus: The posterior keratoconus has minimal opacity. Histopathologically, in Peters anomaly, the corneal endothelium and the Descemet membrane are thin or absent. In posterior keratoconus, the Descemet membrane and the endothelium are present, and the Descemet membrane demonstrates abnormal anterior banding, multilaminar configuration, and/or posterior excrescences.^[28]No iris adhesions are seen in posterior keratoconus.

Sclerocornea: Sclerocornea and Peters anomaly both result from anterior segment dysgenesis and share common findings, including anterior synechiae, posterior embryotoxon, and prominent iris processes. However, Peters anomaly presents with a clear cornea in the periphery, whereas sclerocornea has scleral tissue extension and vascularization in the periphery of the cornea.^[18]In sclerocornea, the entire cornea is opacified and flattened.

Trauma: This includes birth trauma from forceps delivery, which can result in tears in the Descemet membrane and subsequent corneal clouding.

Other differential diagnoses to be considered are as follows:

Intrauterine keratitis
Mucopolysaccharidoses and other metabolic disorders
Congenital hereditary endothelial dystrophy
Corneal dermoids
Congenital glaucoma

Differential Diagnoses

Workup

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Author

Danielle Trief, MD Assistant Professor of Ophthalmology, Columbia University College of Physicians and Surgeons

Disclosure: Nothing to disclose.

Coauthor(s)

Sara K Schroder Barnard College

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Christopher J Rapuano, MD Professor, Department of Ophthalmology, Sidney Kimmel Medical College of Thomas Jefferson University; Director of the Cornea Service, Wills Eye Hospital

Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Ophthalmological Society, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Cornea Society, Eye Bank Association of America, International Society of Refractive Surgery

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: AAO; OMIC; American Society of Ophthalmic Trauma (ASOT); Avellino, Baxis; Bio-Tissue; Celularity; Dompe; Emmecell; Glaukos; Kala; Oyster Point; Sun Ophthalmics; Tarsus; TearLab<br/>Serve(d) as a speaker or a member of a speakers bureau for: Glaukos; Dompe; Bio-Tissue<br/>Received research grant from: Glaukos<br/>Received income in an amount equal to or greater than $250 from: AAO; OMIC; Baxis; Bio-Tissue; Cellularity; Dompe; Glaukos; Kala; Sun Ophthalmics; TearLab<br/>stock options for: RPS, Fount Bio.

Chief Editor

Donny W Suh, MD, MBA, FAAP, FACS Professor, Department of Ophthalmology, Chief of Pediatric Ophthalmology and Adult Strabismus, Medical Director of Eye-Mobile, Gavin Herbert Eye Institute, UC Irvine Health, University of California, Irvine, School of Medicine; Associate Clinical Professor, Department of Pediatrics, Creighton University School of Medicine; Chief Medical Officer, Suh Precision Syringe, LLC; Medical Staff, Children’s Hospital of Orange County

Donny W Suh, MD, MBA, FAAP, FACS is a member of the following medical societies: American Academy of Ophthalmology, American Academy of Pediatrics, American Association for Pediatric Ophthalmology and Strabismus, American College of Healthcare Executives, American College of Surgeons, American Medical Association, Section on Ophthalmology, American Ophthalmological Society, International Strabismological Association, Iowa Medical Society, Metro Omaha Medical Society, National Eye Care Project, Nebraska Chapter of American Academy of Pediatrics, ORBIS, Surgical Eye Expeditions (SEE) International

Disclosure: Received research grant from: NIH / PEDIG.

Additional Contributors

Brian A Phillpotts, MD Ophthalmologist, St Luke's Cataract and Laser Institute

Brian A Phillpotts, MD is a member of the following medical societies: American Academy of Ophthalmology, American Diabetes Association, American Society of Retina Specialists, Association for Research in Vision and Ophthalmology, Association of University Professors of Ophthalmology

Disclosure: Nothing to disclose.

Guruswami Giri, MD, FRCS Vitreo-Retinal Surgeon, Sacramento, CA

Guruswami Giri, MD, FRCS is a member of the following medical societies: American Academy of Ophthalmology, Royal College of Surgeons of Edinburgh, Royal College of Ophthalmologists

Disclosure: Nothing to disclose.

Acknowledgements

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

Peters Anomaly Differential Diagnoses

Diagnostic Considerations

Differential Diagnoses

References

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