Haab striae and endothelial injury in congenital glaucoma

This case highlights the role of multimodal imaging, including in vivo confocal microscopy (IVCM) and anterior segment optical coherence tomography (AS-OCT), in detecting subclinical endothelial damage in a patient with congenital glaucoma. IVCM revealed endothelial polymegathism, reduced cell density, and hyperreflective, acellular linear structures. AS-OCT showed protrusions and hyperreflectivity of the Descemet-endothelial complex. These findings correlate with histopathologic features of Haab striae and suggest that patients with congenital glaucoma may have progressive, yet clinically silent, endothelial dysfunction.