rDVM Quick Reference Guide for this Ophthalmic Emergency

  • Physical Examination
  • Minimize Restraint/Manipulation
  • Systemic Antimicrobials
  • Avoid Topical Anti-Inflammatories
  • Systemic Analgesia
  • E-Collar to Prevent Self-Trauma
  • Refer for Microsurgical Repair

Descemetoceles are deep corneal stromal ulcers that extend to the level of Descemet’s membrane. They represent the most fragile corneal ulcers and are usually easy to detect due to the fact that Descemet’s membrane does not retain Fluorescein stain. A brief physical examination should be performed, but it is very important to minimize restraint and manipulation of the eyelids and globe in patients with a descemetocele as corneal rupture is an imminent risk. Treatment typically comprises topical and systemic antimicrobials, systemic anti-inflammatories, and systemic analgesia. An Elizabethan collar should be placed to prevent self-trauma. Prompt referral for surgical intervention, typically corneal/conjunctival grafting, should be considered to provide the best chance for globe/vision salvage.