Blueberry eye: acquired total anterior staphyloma after a fungal corneal ulcer

Abstract

Purposes: The purposes of this study were to report the presentation and management of an acquired total anterior staphyloma that resulted from a fungal corneal ulcer and to discuss its pathogenesis.

Methods: Observational case report. Clinical observation and surgical intervention of a patient who developed a total anterior staphyloma after a partially treated fungal corneal ulcer.

Results: The patient presented with a large traumatic fungal ulcer but was poorly compliant with follow-up and medications. He subsequently presented with a large total anterior staphyloma that resulted from perforation of the ulcer with plugging of the defect with iris and formation of a pseudocornea over the iris. The anterior staphyloma measured 15 x 16 mm and progressed to a stage where the patient was unable to close his eyelids and required a sclerokeratoplasty. Currently, vision is poor from amblyopia and a cloudy graft; however, the eye is intact and comfortable.

Conclusions: Anterior staphylomas usually result from untreated fungal ulcers in developing nations. Poor compliance with medications and follow-up was the cause of our patient's anterior staphyloma. Sclerokeratoplasty can restore the globe structurally but has poor visual prognosis.