A pulsing descemetocele
Jan 1, 2019
Volume 25, Number 1Clare R. McCloskey, MB BCh
| Royal Victoria Eye and Ear Hospital, Dublin, Ireland
David Dunleavy, MB ChB | Royal Victoria Eye and Ear Hospital, Dublin, Ireland
William Power, MB BCh, MRCPI, FRCSGlasg, FRCOphth | Royal Victoria Eye and Ear Hospital, Dublin, Ireland
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An 82-year-old woman with no significant past medical history initially presented at the Royal Victoria Eye and Ear Hospital, Ireland, with a 1-week history of red eye and blurred vision. She was diagnosed and treated for herpes simplex keratouveitis with secondary raised intraocular pressure. She had poor compliance with treatment and nonattendance at clinic visits. One year later, she developed a superimposed bacterial keratitis, which responded to antimicrobial topical treatment, but with resultant progressive corneal stromal thinning. She underwent two failed corneal gluing procedures, with eventual prominent descemetocele formation. The video shows a large descemetocele pulsing in synchronization with the patient’s heart and blink rate. A Gunderson conjunctival flap was performed. Currently the eye does not have visual potential, but she remains comfortable, with a significantly reduced risk of perforation and its associated complications.