Congenital Buphthalmos
(Glaucoma)

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.

Figure 4A 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.

Figure 4B 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.

Figure 4C 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.