Visual prognosis in patients with ruptures in Descemet's membrane due to forceps injuries.

Seven patients with Descemet's membrane ruptures associated with a forceps injury to the eye at birth were studied. A complete ophthalmological examination was done on each patient, and two patients had ultrasound measurements of the axial lengths of both eyes. We found that the ruptures in Descemet's membrane were single or multiple vertically oriented breaks associated with high astigmatism along the axis of the breaks and deep amblyopia in all patients. The astigmatic errors were corneal in origin. High myopia was also present in the involved eye and was thought to be axial in all patients. Two patients did have elongated axial lengths demonstrated by ultrasonography. The presence of axial myopia and deep amblyopia may relate to partial occlusion of the involved eye during the early postnatal months. The latter possibility is discussed in light of recent reports of myopia induced by early postnatal occlusion in animals.