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Anophthalmos
Overview

Definitions

  • Anophthalmia is a medical term used to describe the absence of the globe and ocular tissue from the orbit.
  • This was first reported more than 400 years ago, yet it is only recently that significant reconstructive options became available.
  • There are many reasons why one might lose an eye.
  • Surgeries which result in anophthalmos

There are three classifications for this condition:

  • Primary anophthalmia is a complete absence of eye tissue due to a failure of the part of the brain that forms the eye.
  • Secondary anophthalmia the eye starts to develop and for some reason stops, leaving the infant with only residual eye tissue or extremely small eyes which can only be seen under close examination.
  • Degenerative anophthalmia the eye started to form and, for some reason, degenerated. One reason for this occurring could be a lack of blood supply to the eye.

Etiology

  1. Anophthalmia ( A medical term used to describe the absence of the globe and ocular tissue from the orbit ) can be congenital (present at birth) or acquired later in life. Congenital anophthalmia can occur alone or along with other birth defects. Cases of Anophthalmia may result from inherited genetic mutations, sporadic genetic mutations, chromosome abnormalities, prenatal environmental insult or unknown.
     
  2. True or primary anophthalmos is very rare. Only when there is complete absence of the ocular tissue within the orbit can the diagnosis of true anophthalmos be made. Extreme microphthalmos is seen more commonly. In this condition, a very small globe is present within the orbital soft tissue, which is not visible on initial examination.
     
  3. Anophthalmia and microphthalmia may occur secondary to the arrest of development of the eye at various stages of growth of the optic vesicle. It is important to recognize microphthalmia because the development of the orbital region, as well as the lids and fornices, is dependent on the presence of a normal-sized eye in utero. Anophthalmia is sometimes a clinical characteristic of Trisomy 13 which is a Gross Chromosomal Abnormality.

     (Anophthalmia is very rare but the exact incidence is unknown. One report from a prospective study of 50,000 newborns found an incidence of microphthalmia of 0.22 per 1,000 live births)
  • trauma
  • infection
  • tumor (such as retinoblastoma, choroidal malignant melanoma)
  • advanced ocular disease (corneal disease, advanced resistant glaucoma)

Demographics

  • Data from the U.S. National Center for Health Statistics estimate that nearly 2.4 million eye injuries occur in the United States annually. This report calculated that nearly one million Americans have permanent significant visual impairment due to injury, with more than 75% of these individuals being blind in one eye. Eye injury is a leading cause of monocular blindness in the United States, and is second only to cataract as the most common cause of visual impairment. While no segment of the population escapes the risk of eye injury, the victims are more likely to be young. The majority of all eye injuries occur in persons under thirty years of age. Trauma is considered the most common cause of enucleation in children over three years of age.
  • For the year 2000, Texas demographics for cancer of the eye and orbit were fewer than five per 100,000. According to the Nilt, there are about 2,200 cases of eye cancer diagnosed in the United States each year


Removal of the eye by enucleation or evisceration can relieve pain and minimize further risk to life and well-being of an individual with the above noted conditions. Goals in Surgery

  • well-tolerated orbital implant
  • excellent appearance
  • good motility

 

 

 

 


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