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Secondary Embryonic Stage
(Definition of a Very Small Globe)

This secondary embryonic stage aberration will show the early formation of an eyeball that may be pellet size to that of a small white pea.  This is the scleral portion of the eye that aborted prior to the development of the cornea and iris.  When the eyelids are separated there will be less of a funnel shape with this bud like globe at back of the orbit.  There will also be the beginning of defined fornices that may help to retain a flush fitting stemmed conformer.  (Note: If a stemmed conformer is used initially in this secondary stage it would only serve to prevent rotation of the flush fitting conformer.)  Externally the eyelid development is also slightly more advanced by being less taut and more supple to the touch.  The projected time before fitting the ocular prosthesis is usually between 6 months to a year.

This case presents a bilateral birth defect that advanced to microphthalmia.  This child had two white pea sized globes which necessitated fitting flush impression moulded expansion conformers rather than the empirically fitted 'trial and error' procedure used with congenital anophthalmia.  The flush fitting conformers will eliminate any chance of causing pressure and/or discomfort to the partially formed globes while continuing to enlarge the orbital periphery, fornices and eyelid apertures.

Figure 2A This young patient responded quite well to stem-less, moulded clear acrylic conformers.  This photo shows the first of three incremental sized conformers.

Figure 2B These bilateral prostheses were fitted in the seventh month.  Note: The prostheses were made with mydriatic (dilated translucent) pupils, because the child had some light perception.

Figure 2C One advantage of being fitted with cover shell prostheses by your local ocularist, is that the proper fit can be monitored, adjusted or refitted when necessary.  This photo was taken 6 years later.

 

   
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Jahrling Ocular Prosthetics, Incorporated
50 Staniford Street, Boston, MA  02114, USA
Members American Society of Ocularists, Board Certified Ocularists