This birth aberration (congenital glaucoma) becomes quite
conspicuous due to continued enlargement of the eyeball caused
by a marked increase in vitreous humor. This build-up
of intraocular pressure (glaucoma) increases the size of
the eyeball and consequently stretches the eyelids while
effecting the levator and orbicularis muscles.
This 9 month old patient presents congenital buphthalmos
(left eye) with signs of extended eyelid aperture.
It became necessary to enucleate this blind and painful eye
3 months later.
An impression moulding was taken during an EUA (examination
under anesthesia) and the first custom made prosthesis was
fitted when the child was 15 months old. Please note
the eyelid aperture and upper tarsal lid fold, since they
still appear wider than the normal right eye.
The close proximity of the child to this laboratory allowed
us to follow up on an annual basis to enlarge, modify and
adjust the prosthesis during her rapid growth in the following
10 years. At this juncture there was sufficient change
in the iris color and scleral tinting to warrant a replacement
prosthesis. The completed prosthesis gave a more symmetrical
aperture although the upper tarsal lid fold was thicker.