Peter’s Anomaly

What is Peter’s Anomaly?

Peter’s Anomaly refers to a congenital corneal opacity (clouding) due to iris–corneal adhesion (Type 1 Peter’s Anomaly) or lens–cornea adhesion (Type 2 Peter’s Anomaly).

What causes Peter’s Anomaly?

Some cases of Peter’s Anomaly are caused by genetic mutations in one of the following genes: PAX6, FOXC1 or PITX2. These genes are responsible for normal tissue development in the anterior part of the eye. However most cases of Peter’s Anomaly are sporadic without other family members being affected.

What are the ocular associations of Peter’s Anomaly?

Glaucoma
Cataract
Microphthalmos
Persistent hyperplasia of primary vitreous (PHPV)
Foveal hypoplasia

What are the systemic associations of Peter’s Anomaly?

Cranial facial anomalies
Congenital heart diseases
Pulmonary hypoplasia
Ear anomalies
Genitourinary anomalies

What are the treatments for Peter’s Anomaly?

Treatment of corneal opacities associated with Peter’s Anomaly are quite difficult due to poorly developed structures in the front part of the eye. Corneal transplantation is very limited in children because their age and poor visual outcome. Corneal opacities can improve spontaneously therefore resulting in fairly useful vision in some children with Peter’s Anomaly. There is higher risk of glaucoma among children with Peter’s Anomaly and regular examinations by an ophthalmologist is needed.

Educational Implications

Behaviours or conditions that might indicate Peters Anomaly

Cloudy cornea, or smaller cornea from birth.
Nystagmus.
Blurred vision.
Vision is worse in bright light due to glare.

What to do

The young person should visit an ophthalmologist to determine diagnosis and treatment.
High risk of glaucoma so regular consultation with ophthalmologist is important.
Blurred vision can sometimes be improved by wearing spectacles or contact lenses.
Wearing dark glasses or a sunhat may help with glare.
Enlargement of print (may be required).
Sit near the front of the class.
Wear tinted glasses.