A child presents with lid lag and an enlarged cornea with a diameter of 13 mm. Examination of the eye reveals double contoured opacities concentric to the limbus. Which of the following is the most likely diagnosis?
**Core Concept**
The child's presentation of lid lag, enlarged cornea, and double contoured opacities concentric to the limbus is suggestive of a condition characterized by corneal enlargement and a specific type of corneal opacity. This condition is associated with a deficiency in a crucial enzyme involved in corneal development.
**Why the Correct Answer is Right**
The child's symptoms are consistent with **Megalocornea** (corneal diameter >13 mm), which is often associated with **Buphthalmos**. Buphthalmos is a condition characterized by corneal enlargement and double contoured opacities concentric to the limbus, resulting from increased intraocular pressure (IOP) due to congenital glaucoma. The increased IOP leads to corneal enlargement and stretching, causing the characteristic double contoured opacities.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is not directly related to the child's symptoms, as it refers to a condition affecting the retina rather than the cornea.
* **Option B:** This option is incorrect because it refers to a type of corneal dystrophy that affects the corneal endothelium, causing corneal edema, but does not explain the child's enlarged cornea and double contoured opacities.
* **Option C:** This option is incorrect because it refers to a type of uveitis, which is inflammation of the uvea, and does not explain the child's corneal enlargement and double contoured opacities.
**Clinical Pearl / High-Yield Fact**
In cases of congenital glaucoma, it's essential to diagnose and treat the condition early to prevent permanent vision loss and corneal damage. A key clinical feature of congenital glaucoma is the presence of a blue-gray coloration of the sclera, known as Haab's striae.
**Correct Answer:** C.