Retrocorneal membrane with Descemet's detachment

Purpose. To describe a unique case of retrocorneal membrane with large Descemet's detachment. Methods. Case report of a 65-year-old man reported intermittent cloudy vision in his left eye. The patient underwent serial ocular examinations and slit-lamp photography over 6 weeks. Results. The patient had an inflammatory-appearing membrane that covered 60% of the posterior cornea, with a subtotal Descemet's detachment. Vision was stable at 20/20, and the cornea remained clear. The patient was empirically treated with topical neomycin/polymyxin/dexamethasone, sodium chloride, and oral acyclovir, and his symptoms improved; however, the retrocorneal membrane persisted. Conclusion. This unusual clinical finding may represent reduplicated Descemet's membrane with partial Descemet's detachment secondary to occult deep herpes simplex keratitis. Other possibilities include spontaneous or traumatic Descemet's tear and detachment.