Clinical

Microblepharon is a very rare congenital anomaly that should be distinguished from cryptophthalmos where the eyelids are not formed but skin extends across and over a deformed eye or are fused to a disrupted globe. In microblepharon the eyelid margins are formed and the underlying globe is normal.

CHARACTERISTICS In microblepharon the eyelid margins are normal but there is a vertical shortening of the lids to varying degrees. The condition may be unilateral or bilateral and can involve both upper and lower eyelids. The shortened lids cause significant lagophthalmos, corneal exposure, and cosmetic deformity. The corneal exposure is associated with symptoms of photophobia, foreign body sensation, and epiphora. If neglected, the cornea can become opaque with dellen formation and even perforation.

(Courtesy of Richard L. Anderson, M.D.)

TREATMENT Correction of microphthalmos requires vertical lengthening of the eyelid. The technique will depend upon the degree of eyelid tissue anomaly. For the posterior lamella a hard palate mucosal or chondromucosal graft can be used. For the anterior lamella skin grafts are often needed. Surgery should be timed according to the severity of corneal exposure and the potential development of amblyopia. In severe cases intervention may be indicated within the first few weeks or months of life.

(Courtesy of Richard L. Anderson, M.D.)

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