History
History may reveal the following:
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Pain - External-type pain alleviated by topical anesthesia
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Blurry vision - Mild to moderate if only stromal edema; moderate to severe if epithelial edema too; can severely affect vision
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Foreign body sensation – External symptoms alleviated by topical anesthetic
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Tearing due to external symptoms
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Eyelid swelling if corneal edema is severe
Physical
Descemet folds are directly visible with slit lamp biomicroscopy using direct focal illumination, specular reflection, and retroillumination. [3]
Descemet folds are associated with corneal edema due to endothelial dysfunction from infections, from infiltrations, or following surgery.
Descemet folds also are associated with corneal inflammation due to infections or infiltrations or following surgery.
Descemet folds also are associated with anterior chamber inflammation visible by direct focal illumination.
Causes
The following are potential causes of Descemet folds:
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Inflammation due to corneal or ocular infection
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Inflammation after surgery; normal postoperative inflammation or exuberant inflammatory response can be due to complicated surgery, retained lens fragments, retinal detachment, or endophthalmitis.
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Inflammatory conditions, such as blepharitis, phlyctenulosis, episcleritis, and scleritis
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Trauma or injury, such as blunt trauma or acidic/alkaline chemical injury
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Descemet membrane folds after surgery.
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Diffuse illumination showing Descemet membrane folds after surgery.
