|
|
CASE REPORT |
|
Year : 1984 | Volume
: 32
| Issue : 1 | Page : 41-43 |
|
Euryblepharon
SM Betharia, Y Dayal, RC Nayar
Dr. RP. Centre for Ophthalmic sciences, AIIMS, New Delhi, India
Correspondence Address: S M Betharia Lecturer, R.P. Centre, AIIMS, New Delhi-110 029 India
Source of Support: None, Conflict of Interest: None | Check |
PMID: 6500664
How to cite this article: Betharia S M, Dayal Y, Nayar R C. Euryblepharon. Indian J Ophthalmol 1984;32:41-3 |
Euryblepharon is a rare congenital anomaly in which there is symmetrical enlargement of the palpebral aperture associated with large eyelids.[2],[8]
The average lid fissure lengths vary with age from 18.35 mm at birth to 29.68 mm at 2426 years by various authors.[2],[9] some authors[7] give the measurement of normal palpebral aperture vis-a-vis the age as 18.5 to 19 mm X 10 mm (new born); 24-25 mm X 13 mm (Infant). 28-30 mmX14-15 mm (adult) and 28X11-12 mm (old age).
This is the first case report in a total of 306 lid anomaly cases seen at this centre from 1975-79. It describes certain peculiarities of the anomaly seen and the correction of the anomaly by Goldstein's modification of lateral canthoplasty.
Case report | | |
The patient, V.K, 23 year Male attended the RAPCOS Hospital with complaint of watering from both eyes. The local ocular examination showed symmetrical enlargement of the palpebral aperture. The lateral can thus area showed a depression lined by conjunctiva on its floor limited by globe medially and lateral can thus laterally. There were tears accumulated in this "lacus lacrimal is LATERALIS;; and were constantly dubbing over. There was congestion of conjunctiva laterally. The lacrimal puncta were well apposed and the lacrimal passages patent. There was no other ocular or systemic anomaly found.
Family members: The various measurements of the palpebral apertures are enumerated in [Table - 1]. The ocular and systemic examination was essentially normal and there were no symptoms.
The patient V.K underwent Goldstein's modification of lateral canthoplasty [Figure - 1][Figure - 2]. The postoperative period was uneventful and there was no more watering from the eyes.
Discussion | | |
This case of Euryblepharon with `lacus lacrimalis lateralis" is peculiar in causing symptoms of epiphora. The possible mechanism appears to be stasis of secretion of tears with infection (congestion in lateral conjunctiva) would cause reflex increased secretion of tears which tend to overflow. We believe the presence of lacus lacrimalis lateralis as essential for the euryblepharon to be symptomatic as the rest of family members though Euryblepharon but none had problem of epiphora. However, the obliteration of the lacus lacrimalis lateralis by a lateral canthoplasty would relieve the patient of the epiphora as shown in this case helps to substantiate the hypothesis of stasis, infection and reflex increased secretion.
We have found both vertical and horizontal enlargement of palpebral-apertures.
We advocate the clinical classification of euryblepharon into complete and incomplete forms, wherein both vertical and horizontal enlargement occur in the complete form and only horizontal enlargement in the incomplete form.
As far as heredity is concerned it shows autosomal dominant features. In our study the mother and all the 4 children show euryblepharon either in complete or incomplete forms (See family tree & [Figure - 3].[11]
References | | |
1. | Desmanres, LA., 1854: Triate The 'Onque et Poatique des maladres, des Yeu'x, Vol p 468 Paris. |
2. | Duke Elder S., 1964: System of Ophthalmology Vol. 3, pt. 2 p 841 Kimpton, London. |
3. | Duke Elder S, and Cook, C. 1963: Ide, Vol. 3, Pt. p. 310. |
4. | Gupta, J.S. and Kumal, K.,. 1968: Amer. J. Opthalmol., 66, 554 |
5. | Gupta, AX Rama Murthy, S., Sukla, K, 1972: J. Paed. Ophthalmol., 9: 173 |
6. | Last, R.J., 1968: Eugene Wolff's Anatomy of the Eye and Orbit, 6th Ed. p. 203, Lewis, London. |
7. | Lindberg, J.G., 1928: Klin. Kbl. Augen Heilk 81. 665. |
8. | Kerpert, J.A., 1975: Brit. J. Ophthal. 59: 57-58. |
9. | Waardenburg, P.J., Franceschctti, A. and Klein, D., 1961: Genetics and Ophthalmology, Vol. 1, p. 253', Blackwell Scientific Publications, Oxford |
10. | Wolter, JR., 1972: J. Paed. Opthal., 9: 135. |
11. | Warwick, R and Williams, P.L., 1973: Grey's Anatomy 35th Ed. p. 497, Longman, Edinburgh. |
[Figure - 1], [Figure - 2], [Figure - 3]
[Table - 1]
|