Microphthalmia
Microphthalmia is an
eye condition where the globe size is at least
two standard deviations below the average size
for a child of a comparable age.
Microphthalmia can be either simple or
complex. Simple microphthalmia refers to an
intact eye with shortened total length of the
globe; complex microphthalmia refers to
malformation of various parts of the eye in
addition to its small size. These eye conditions
are caused by chromosomal abnormalities or
prenatal exposure to rubella, toxoplasmosis,
alcohol, thalidomide, hydantoin, or LSD that
damage the developing eye before birth which makes it a congenital disease.
Treatment
There is no cure for these conditions, but many
treatments are available to the child and family.
A computerized tomogram (CT) or magnetic
resonance imaging (MRI) will be needed to
determine the extent of defect. The optic nerve
and extraocular muscles will need to be
carefully examined. A genetic workup would
be advised with family counseling as indicated.
No treatment is needed for mild or moderate
microphthalmia. Prosthetics will be used in
anophthalmia as well as surgery to expand the
palpebral fissures (opening of the eye between
the upper and lower lids) and orbit (boney eye
socket). Reconstructive surgery is typically
performed a bit later in childhood to allow
growth of the facial bones, although there may
be some preliminary surgeries done earlier. It
will be important to have regular visits to eye
specialists who will fit conformers (eye
prostheses) that are increased in size as the
child grows.
Functional Implications
Early intervention in special programs for
children with blindness or low vision is
essential to assist the child to increase sensory
input as they develop. Motor development can
be on a somewhat different timeline for infants
and young children with visual deficits since
they may need adaptations and assistance to
explore their environment safely.
Children with blindness or partial sight may
have learning difficulties or behavioral
concerns. This is because other parts of the
brain form at the same time as the eyes. A
great deal of special help is available through
the school system to children and families with
vision difficulties, and many occupational
therapists have special training to assist them.
Linda L. Lindeke, Ph.D., R.N., C.N.P.
Associate Professor University of Minnesota
School of Nursing & Department of Pediatrics
References
Linideke, L., retrieved July 7, 2011 from
retrieved July 7, 2011 from http:directory.net
retrieved July 7, 2011 from
retrieved July 7, 2011 from
retrieved July 7, 2011 from