Indian Journal of Ophthalmology

ARTICLES
Year
: 1974  |  Volume : 22  |  Issue : 4  |  Page : 24--25

Bilateral cryptophthalmos


Brajananda Das 
 M.K.C.G. Medical College, Berhampur, Ganjam, Orissa, India

Correspondence Address:
Brajananda Das
Assistant Professor of Ophthalmology, Maharaja Krushna Chandra Gajapati Medical College, Berhampur, Ganjam, Orissa
India




How to cite this article:
Das B. Bilateral cryptophthalmos.Indian J Ophthalmol 1974;22:24-25


How to cite this URL:
Das B. Bilateral cryptophthalmos. Indian J Ophthalmol [serial online] 1974 [cited 2020 Jun 5 ];22:24-25
Available from: http://www.ijo.in/text.asp?1974/22/4/24/31346


Full Text

Cryptophthaloms is a congenital anomaly in which there is complete failure of formation of lid folds, so that skin passes from the forehead onto the cheek over the eye, which is hidden underneath (cryptos means hidden). [1]

This condition is a very rare. Only about 50 cases have been reported since Zehender and Manz's (1872) original observation as quoted by Duke E1der. [1] A case of bilateral cry­ptophthalmos was reported by Singh. [2]

Cryptophthalmos is usually seen associated with other congenital abnormalities such as cleft palate, harelip, ventral hernia, malformed concha, meningo-encephalocele, genital mal­formations etc. [1] Attempt at surgical separa­tion of eye ball from the overlying skin is associated with its perforation as cornea is usually seen replaced in whole or part by vascularised tissue blended with skin. [2],[3],[4]

 Case Report



A male child [Figure 1] aged one day was brought by his parents to Eye O.P.D., M.K.C.G. Medical College Hospital, Berhampur with history of absence of eyes since birth. There was no family history of any deve­lopmental anomalies. No history of veneral disease, abortion or eruptive fever during pregnancy. The baby had six other normal living brothers and sisters.

On examination, the baby was of average built with no other congenital malformations except some depression over tip of nose. Both eyes were covered with skin, which was found to be in continuation with that of forehead and cheek. There were neither eye brows nor palpebral fissures on either side, but on the left side, a faint rudimentary mark of fissure or chink was seen on lateral aspect with a few downy eye lashes. The eye balls could be felt separate from the overlying skin. [Figure 1]

Systemic examination did not reveal any abnor­mality. The parents insisted on getting the eyes ex­posed surgically at least for cosmetic purpose, although they were convinced of the fact that the eyes would be of no use functionally. Thus with relutance, I ex­posed the eyes under general anaesthesia one after another at an interval of a week. Incision was made over the region of palpebral fissures from the lateral aspect. The balls could be separated from the overlying skin and vascular tissue layer without much difficulty, although there was associated bleeding. Cornea was exposed well and separation of vascular tissue was made complete from the limbus and sclera as far as practicable. Interrupted sutures were given in the lid margins including skin and the underlying conjunctiva, which was somewhat rudimentary.

Postoperatively, the lid margins were separated from the eye ball daily by a blunt probe smeared with corticosteroid antibiotic ointment and lid stiches were removed after a week of operation. On the left side, wound healed up without complication but on the right side, bleeding was quite marked while separating the lids from the eye ball during the post operative period. [Figure2]

The following characteristic features were noted about this case.

(a) Bilateral affection. (b) Absence of history of hereditary or familial affection. (c) Presence of deve­lopmental anomaly in the form of depressed bridge of nose. (d) Cornea and sclera could be easily separated from the overlying skin. (e) Cornea appeared smooth, thin and flattend to which iris tissue was found to be adherent, thus obliterating the anterior chamber. (f) Sclera appeared thinned out and bluish with irregular bulgings suggesting staphylomatous condition. (g) Ab­sence of retinal function as noted by absence of move­ments of eye ball or lid on exposure to strong light.

 Summary



A rare case of bilateral cryptophthalmos is presented with characteristic features.

References

1A.R. Chaudhari, 1969, Medicus (Karachi), 38 169.
2 Duke Elder S, 1964-System of Ophthalmology, 829, Henry Kimpton, London.
3Singh N. 1973, Bilateral Cryptophthalmos. The Antiseptic Vol. 70, No. 2, 125.
4 V.K. Dada, and Aggarwal, 1969, Oriental Arch. Ophthal, 7, 126.