Brown-McLean syndrome

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An 80-year-old Chinese man with high myopia and a history of right eye cataract extraction and superior peripheral iridectomy developed peripheral corneal oedema after a period of aphakia. The peripheral corneal oedema was static over years and did not progress to involve central cornea hence his visual acuity remained stable. The condition was compatible with the relatively rare Brown-McLean syndrome. Specular microscopy showed normal endothelial cell density in the oedematous peripheral as well as central cornea. While anterior segment optical coherence tomography demonstrated the cross-sectional architecture of cornea, Scheimpflug imaging was used to measure the peripheral corneal thickening and to demonstrate increased corneal density as compared with the contralateral normal eye. These investigations not only help better characterise the rare disease, but also in precisely monitoring any disease progression by periodic measurements.

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