Tertiary Embryonic Stage
This final embryonic stage aberration just falls short of
being a normally developed functional eye. It is a
miniaturization in all aspects with a micro-cornea and iris.
The eyelids although narrower, will respond quite readily
to 2 to 4 increased in thickness impression moulded flush
fitting conformers. This usually is over a period of
3 to 6 months. (Note whenever there is definition of
a globe especially with a clear cornea it is best to fit
clear acrylic impression moulded conformers. This allows
the ocularist to check for any pressure points on the eye
or displacement of the conformer during excursion to the
four quadrants and obliques.)
As a side note, we have gone through the process of expanding
the eyelid aperture in several more advanced microphthalmic
globes where the final flush fitting moulded clear acrylic
conformer became final product. It gave enough magnification
to serve as a 'cosmetic optics' scleral shell and did not
require a hand painted iris cover shell prosthesis.
This young girl (with true microphthalmos) was 4 years old
when first fitted with a scleral ocular prosthesis.
(Note the typical hyperpalpebral fissure for this embryonic
Placement of a 'full thickness' scleral ocular prosthesis
gave a near symmetrical alignment with the fellow sighted
This same patient seventeen years later displays little characteristic
change in the formation of the hyperpalpebral aperture when
the prosthesis is removed.
The horizontal aperture will measure less to allow the prosthesis
to move into the inner and outer canthus with lateral gaze.