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What Is Congenital Anophthalmia And Microphthalmia?
Anophthalmia and microphthalmia are rare birth defects that
are characterized by the malformation of the tissues of the
eye. These defects most often lead to permanent blindness
and possible physical disfigurement due to the absence of
normal ocular tissues.
The condition is believed to be influenced by genetic factors
but may also be linked to exposure to environmental influences
such as toxins, microbes, radiation, etc.
The tissues of the eye and orbit do not develop early in
the gestational period. Therefore the eye socket and soft
tissues of the lids do not grow in proportion as would a normal
eye and thus the bone and soft tissues remain small and disfiguring
in appearance.
Having a child with any form of birth defect is devastating
for any family. The attached video link consists of excerpts
from the video You, Your Baby and
Anophthalmia. This video surveys real life experiences
of families with anophthalmic children.
Video courtesy of the Delta Gamma Center for Children with
Visual Impairments, St. Louis, MO. A Full length VHS copy
of the video may be obtained by contacting the organization
at 314/776-1300
Treatment Options
Most experts agree that the earlier expansion treatment is
started the more effective it can be. It is important to consult
with specialists early in the child's development to establish
the best course of action.
In general, the treatment methods consist of mechanical expansion
of the affected area. Every case is different and may require
both the expansion of the soft tissue of the eyelids and exposed
socket but also the hard bone that makes up the orbital rim
and shapes the face.
In most cases, an orbitofacial reconstructive specialist
and/or pediatric ophthalmologist will team up with an ocularist
in the management of the reconstructive process. An ocularist
is an artistic professional that specializes in the custom
fabrications of cosmetic prosthetic eyes.
The typical expansion of the soft tissues of the eye socket
consists of the placement of several stages of consecutively
larger plastic wedges just behind the eyelids. This technique
is performed up to several months to gradually make space
for a permanent prosthesis to provide a more normal looking
appearance.
The soft tissues of the eyelids and socket expand differently
than the hard tissues of the bony orbit so additional techniques
may be necessary. The expansion of the bony orbit is important
to help establish skull symmetry as the child grows.
There are several devices and techniques to assist with the
development of the bony orbit. These consist of: Inflatable
balloon expanders, dermis fat grafts and/or the placement
of ordinary orbital implants.
These methods have been the standard for many years but the
desire for more rapid and predictable results led to the development
of the self-inflating hydrogel tissue expanders to provide
more options for patients and their families.
The technology to restore blindness may never exist but the
ability to restore a more normal looking appearance has improved
with the recent addition of this new technology to the treatment
regimen.
As in any medical condition requiring surgery, patients and
their families are encouraged to seek the advice of several
professionals experienced in the field of treatment as to
what is the best course of action for each particular case.
For the latest information regarding osmotic expansion prostheses
and specialist referrals, please E-mail us at expander@iopinc.com
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