Forceps-induced birth injury to the cornea.

A 72-year-old man was referred for cataract surgery in the right eye. On slit-lamp biomicroscopy he was noted to have a vertical split in the Descemet's membrane in the left cornea. Based on the appearance, orientation of the split and medical history of forceps delivery, a forceps injury to the left cornea was diagnosed. The break in Descemet's membrane is characteristically vertical due to the horizontal stretching of the globe which occurs with vertical compression of the globe between the orbit and the blade of the obstetric forceps. Forceps injuries are usually unilateral and affect the left eye as the most common fetal head position is left occiput anterior. In the immediate postpartum period the rupture in the Descemet's membrane leads to corneal oedema which eventually disappears leaving the visible edges of the break. This injury also leads to severe left eye astigmatism and secondary amblyopia.