Tertiary Embryonic Stage
(True Microphthalmos)

This final embryonic stage aberration just falls short of being a normally developed functional eye.  It is a miniaturization in all aspects with a micro-cornea and iris.  The eyelids although narrower, will respond quite readily to 2 to 4 increased in thickness impression moulded flush fitting conformers.  This usually is over a period of 3 to 6 months.  (Note whenever there is definition of a globe especially with a clear cornea it is best to fit clear acrylic impression moulded conformers.  This allows the ocularist to check for any pressure points on the eye or displacement of the conformer during excursion to the four quadrants and obliques.)

As a side note, we have gone through the process of expanding the eyelid aperture in several more advanced microphthalmic globes where the final flush fitting moulded clear acrylic conformer became final product.  It gave enough magnification to serve as a 'cosmetic optics' scleral shell and did not require a hand painted iris cover shell prosthesis.

Figure 3A This young girl (with true microphthalmos) was 4 years old when first fitted with a scleral ocular prosthesis.  (Note the typical hyperpalpebral fissure for this embryonic stage.)

Figure 3B Placement of a 'full thickness' scleral ocular prosthesis gave a near symmetrical alignment with the fellow sighted eye.

Figure 3C This same patient seventeen years later displays little characteristic change in the formation of the hyperpalpebral aperture when the prosthesis is removed.

Figure 3D The horizontal aperture will measure less to allow the prosthesis to move into the inner and outer canthus with lateral gaze.