Download anophthalmia_stilwell

Anophthalmia/Microphthalmia
(A/M)
Anophthalmia and microphthalmia are
often
used
interchangeably.
Microphthalmia is a disorder in which
one or both eyes are abnormally small,
while anophthalmia is the absence of
one or both eyes. These rare disorders
develop during pregnancy and can be
associated with other birth defects.
True or primary anophthalmos is very
rare. Only when there is complete
absence of the ocular tissue within the
orbit can the diagnosis of true
anophthalmos be made. Extreme
microphthalmos
is
seen
more
commonly. In this condition, a very
small globe is present within the
orbital soft tissue, which is not visible
on initial examination.
causes:
A/M can be congenital (present at birth) or
acquired later in life. Causes of these
conditions
may
include
genetic
mutations and abnormal chromosomes.
Researchers
also
believe
that
environmental
factors,
such
as
exposure to X-rays, chemicals, drugs,
pesticides, toxins, radiation, or viruses,
increase the risk of anophthalmia and
microphthalmia, but research is not
conclusive. Sometimes the cause in an
individual
patient
cannot
be
determined.
treatment:
There is no treatment for severe anophthalmia or
microphthalmia that will create a new eye or
restore vision. However, some less severe forms
of microphthalmia may benefit from medical or
surgical treatments. In almost all cases
improvements to a child's appearance are
possible. Children can be fitted for a prosthetic
(artificial) eye for cosmetic purposes and to
promote socket growth. A newborn with
anophthalmia or microphthalmia will need to visit
several eye care professionals, including those
who specialize in pediatrics, vitreoretinal disease,
orbital and oculoplastic surgery, ophthalmic
genetics, and prosthetic devices for the eye.
Each specialist can provide information and
possible treatments resulting in the best care for
the child and family. The specialist in prosthetic
diseases for the eye will make conformers,
plastic structures that help support the face and
encourage the eye socket to grow. As the face
develops, new conformers will need to be made.
A child with anophthalmia may also need to use
expanders in addition to conformers to further
enlarge the eye socket. Once the face is fully
developed, prosthetic eyes can be made and
placed. Prosthetic eyes will not restore vision.
A painted prosthesis that looks like a normal eye
is usually fitted between ages one and two. Until
then, clear conformers are used. When the
conformers are in place the eye socket will look
black. These conformers are not painted to look
like a normal eye because they are changed too
frequently. Every few weeks a child will progress
to a larger size conformer until about two years of
age. If a child needs to wear conformers after
age two, the conformers will be painted like a
regular prosthesis, giving the appearance of a
normal but smaller eye. The average child will
need three to four new painted prostheses before
the age of 10. Children with microphthalmia may
have some residual vision (limited sight). In these
cases, the good eye can be patched to
strengthen vision in the microphthalmic eye. A
prosthesis can be made to cap the
microphthalmic eye to help with cosmetic
appearance, while preserving the remaining sight.
There are several support and
resource organizations that deal
with these conditions. A few are
The
American
Society
of
Ophthalmic
Plastic
and
Reconstructive Surgery (ASOPRS),
The
International
Children’s
Anophthalmia & Microphthalmia Network (ican),
and the Micro & Anophthalmic Children’s Society
or MACS.
sources:
Dictionary of Eye Terminology 5th Ed., Barbara
Cassin and Melin L. Rubin, MD, Editor, 2006.
Gainesville: FL, pg .
http://en.wikipedia.org/wiki/Anophthalmia
http://en.wikipedia.org/wiki/Microphthalmos
http://www.anophthalmia.org/
http://www.macs.org.uk/index.html
http://www.nei.nih.gov/health/anoph/
http://www.angelfire.com/mi/microphthalmia/m
ap.html
developed by: Darren Stilwell