From questions on page 281

1. WHAT CAUSED THE CORNEAL OEDEMA IN THESE PATIENTS?

These patients did not have a family history of Fuchs corneal dystrophy or a history of trauma or surgery. There was no evidence of inflammation or corneal guttata. A review of their medications revealed the use of amantadine, which has reportedly caused corneal oedema.

2. WHAT IS YOUR MANAGEMENT OF THESE PATIENTS?

Before the cause of oedema was recognised, case 1 had been scheduled for corneal transplantation. In both cases, the only intervention was to stop amantadine. In case 1, the patient described normalisation of her vision within 10 days of discontinuation of amantadine. At 1 month’s follow-up, her best corrected visual acuities were 20/20, right eye and 20/25, left eye. By slit-lamp …