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This one-month-old infant was born with bilateral corneal opacities that are close to the visual axis and synechiae between the iris and lens in both eyes. A TORCH (Toxoplasmosis, Rubella, Cytomegalo virus, Herpes) screening was done. Testing for IgG was positive for herpes simplex and rubella virus. White blood cell count was 13.83 (normal 9.00 to 12.00) with 67% lymphocytes. The erythrocyte sedimentation rate was normal. The fundus appears normal, but the pupil dilates poorly because of the synechiae, and the intraocular pressure was 13 mmHg in both eyes.

1.	The clinical picture and findings are compatible with:
	e -- all of the above All of the above options are correct.
2.	A concern to be dealt with very soon is:
	d -- amblyopia With the corneal opacity very close to the visual axis and also having the potential to produce astigmatism, amblyopia is a concern.
3.	Another condition to be ruled out is:
	a -- bilateral Peter's anomaly Bilateral corneal opacities and synechiae are present in Peter’s anomaly but in this case they are posterior synechiae; that is, between the iris and lens.  However, a careful look in the anterior chamber should be obtained.
	This is the answer of an expert mentor when this case was submitted for E-Consultation: This definitely is a challenging case. Positivity of Rubella and Herpes obviously lead us to think of an intrauterine infection as the cause of this problem. And this might be the most probable diagnosis. Are the synechia only between iris and lens? Because if there are synechia also to the leucoma another diagnosis to consider is bilateral Peter´s anomaly. Do you have the possibility to perform an Utrabiomicroscopy to have an idea how is the situation of the anterior chamber? This will be of great help in order to plan a treatment. If the lens is clear a bilateral corneal transplant will be indicated. In the mean time maintaining dilation of the pupil with tropicamide might help the child to see lateral of the central leucoma and develop some vision. Editor:  Please note that we invite our overseas partners from those developing countries ORBIS serves to enroll in Cyber-Sight E-Consultation to receive free case consultation.