An Unusual Presentation of Chandler Syndrome: Report of A Case and Brief Discussion

Purpose: To report an unusual presentation of chandler syndrome Case report: A 22-year-old female came to our clinic with complaint of progressive visual loss in her left eye since three days ago. She had a history of trauma with finger-nail to her left eye eight days ago and had been managed with topical antibiotic. In her examination, the left eye had visual acuity (VA) of counting finger at three meters, with intraocular pressure (IOP) of 14 mmHg, and there was a 3+ corneal stromal edema without epithelial defect. After medical management when edema decreased, specular biomicroscopy revealed decreased endothelial cell count and increased average cell size, pleomorphism and polymegathism, and epithelial transformation in the left eye and normal indices in the right eye. After one month, edema was completely resolved and VA improved to 20/25 but specular biomicroscopy remained abnormal. Chandler variant of iridocorneal endothelial syndrome (ICE) was diagnosed. Conclusion: Although corneal edema after blunt trauma is a usual manifestation, in long lasting edema after trauma, we should consider other possible endothelial causes of stromal edema including toxic insult, inflammatory processes, and endothelial dystrophies.