Congenital Microphthalmia

Microphthalmia (microphthalmos) is a congenital condition in which the eye(s) started to form during pregnancy but for some reason stopped, leaving the infant with small eye(s). 

The size of the eye can vary from child to child.  If very mild, it can almost go unnoticed, but usually it is fairly obvious.  At the other end of the scale there is extreme microphthalmia, which is almost the same as anophthalmia.

A newborn with microphthalmia must be seen by an ophthalmologist, ocularist and also an oculoplastic surgeon. 

The orbits (eye sockets) are very important for proper growth and development of the face.  If an eye is missing or too small, the bones around the eye may not grow properly.  A conformer is a a device made by the ocularist that can be placed inside the orbit to help support the growth of the eye socket and the bones in the face.  As the child grows, and the orbits and facial bones develop, the ocularist can also make custom made artificial eyes.  Each child is different,so ,  the age when the child is ready for a prosthetic eye varies.  The ocularist works closely with the ophthalmologist and oculoplastic surgeon to make conformers and prosthetic eyes that are the best possible for the child.  Sometimes surgery may be recommended to implant a prosthetic device deep into the orbit in order to make it easier to fit the prosthetic eye. There are various surgical options available when the conformers are not enough alone due to lid structure issues or socket issues.

  The child may need to be followed up periodically when the condition is seen to be stable and there are no other complications. If the eye is small or badly malformed, then an artificial eye or custom  scleral shell or prosthesis) can be fitted for cosmetic reasons and also for promoting socket growth.

If the microphthalmia is unilateral and causing reduced vision in that eye, then the ophthalmologist should prescribe protective glasses with polycarbonate lenses to protect the better eye from injury.

Vassardanis International Prosthetics 2018