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