Microphthalmic and Phthisical Globes
(Duplicate an Imperfection to Obtain Perfection)

To duplicate or not to duplicate that is the question.  When there are ocular abnormalities in the sighted eye it may be necessary to replicate the deficiency to obtain a more natural appearing prosthesis for facial symmetry.  The two presentations would fall into this category.  One is a congenital anomaly (microphthalmic globe) and the other is an acquired (phthisical globe).

Figure 11A This young patient had bilateral congenital anomalies, (Secondary Embryonic Stage Microphthalmos) of the right eye, and (Coloboma of the Iris) in the left sighted eye.

Figure 11B Duplication of a defined iris coloboma in this full thickness cover shell prosthesis gave symmetrical facial balance.

Figure 12A This case presents an acquired phthisical globe (left eye) following unsuccessful retina surgeries.  The eye to be duplicated shows a surgically induced coloboma following an old cataract extraction.

Figure 12B The full thickness cover shell prosthesis restored orbital volume and palpebral fissure symmetry.  The simulation of the post-operative cataract (pupil) gave balance and was undetectable when wearing his prescription lenses (not shown).

Figure 12C In many phthisical globe conditions the impression moulded trial shell and the prosthesis can be as large as those wearing a prosthesis after an enucleation (with or without an implant).