Laboratory Studies
Elucidate and treat the underlying condition causing the inflammation. Most of the ophthalmic evaluation is clinical. Consider herpes simplex for epithelial infection or stromal infiltrations, which may need impression cytology studies.
Imaging Studies
B-scan ultrasound can be considered if the view to the posterior pole is obscured.
Ultrasound biomicroscopy (UBM) can be helpful to identify foreign bodies in the angle, iris, or anterior sclera, especially after trauma. UBM may be helpful if the view to the anterior chamber angle is obscured.
Other Tests
Gonioscopy may be helpful to reveal retained lens fragments in the anterior chamber angle.
Procedures
Surgery may be necessary either to replace the cornea if the endothelium is not functional or to treat the underlying cause of inflammation (eg, retinal detachment, retained lens fragments, intraocular foreign body).
Histologic Findings
Corneal donor button from penetrating keratoplasty shows corneal stromal edema with fixed folds of the Descemet membrane.
Staging
Staging is not standardized but can be described as 1 to 4 with 1+ implying mild and 4+ implying severe folds.
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Descemet membrane folds after surgery.
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Diffuse illumination showing Descemet membrane folds after surgery.
