• Users Online: 1500
  • Home
  • Print this page
  • Email this page

   Table of Contents      
ARTICLE
Year : 1966  |  Volume : 14  |  Issue : 5  |  Page : 225-226

Bilateral cryptophthalmos (ablepharon)


Department of Ophthalmology, Medical College, Nagpur, India

Date of Web Publication17-Jan-2008

Correspondence Address:
Ishwarchandra
Department of Ophthalmology, Medical College, Nagpur
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


Rights and PermissionsRights and Permissions

How to cite this article:
Ishwarchandra, Mulak J S. Bilateral cryptophthalmos (ablepharon). Indian J Ophthalmol 1966;14:225-6

How to cite this URL:
Ishwarchandra, Mulak J S. Bilateral cryptophthalmos (ablepharon). Indian J Ophthalmol [serial online] 1966 [cited 2021 Jul 28];14:225-6. Available from: https://www.ijo.in/text.asp?1966/14/5/225/38660

Cryptophthalmos is a condition of complete absence of lid folds. The ectoderm which should normally form conjunctiva and corneal epithelium is differentiated into skin to protect the eye ball. Two types of cryptophthalmos may exist, one due to initial failure of lid folds (ablepharon by agenesis), the other due to subsequent destruction or absorption of conjunctival sac (ankylo­blepharon by ankylosis).

The condition is rare, some 50 cases have been recorded since Zehender and Manz's original observation (1872). Avizonis (1928) collected 37 cases from 27 authors of which 29 were typical and only 20 bilateral. In India Pahwa (1960) has reported 2 cases and Gupta and Saxena (1962) one case of bilateral cryptophthalmos.

This is usually associated with other anomalies, frequently deformities con­nected with the "fissures of face" e.g. cleft palate. hare lip, facial cleft. Other anomalies met with are der­moids, syndactly of hands and feet, genital and deep seated anomalies such as aplasia of kidney and atrasia of larynx.


  Case Report Top


A male child, 3 days old was ad­mitted on 21st December, 1965, as the parents observed that both the eye balls were completely covered by skin.


  Obstetrical and Family History Top


The pregnancy was uneventful and the birth of the child was normal. The present case is the second child. The first female child died after 9 days.

There is no history of such deformity in the family.

On examination the growth of the child was found normal. There were no other developmental anomalies ex­cept cleft palate of group II (Davis and Ritchie). The nose was flat and broad.

The eyebrows were partly developed, especially on the lateral side [Figure - 1], lashes were absent.

Both the eyes were completely co­vered by skin, which was continuous with the skin of the forehead and cheeks. There was no linear scar in the region of the palpebral aperture. The rounded prominence of the eye ball could be seen and felt under the skin, which sometimes showed sponta­neous movements. There was no wrinkling of the skin or any movement of the eye ball when exposed to light.

X-ray of skull and orbit was normal.

The rounded prominence on the right side was explored on 6-1-1966, by a horizontal incision about I cm. long in the region of the palpebral fissure and deepened to an extent of 4-5 mm. The skin was undermined on either side. No evidence of conjunctiva or cornea was found. The incised tissue had a fibro-fatty character. A small piece was excised and sent for histo­pathological study, which showed fibro-fatty tissue and striated muscle fibres [Figure - 2].


  Discussion Top


The presence of muscle tissue in the section [Figure - 2] shows that orbicularis oculi was developed, but other lid structures were missing.

As a general rule the anterior seg­ment of the globe is disorganised, in these cases the ectatic cornea being replaced in whole or in part by fibrous tissue blended with the skin (Duke­-Elder, 1964). On exploration, this case showed only fibro-fatty tissue, which suggests that the anterior seg­ment was disorganised. It was ob­vious, therefore, that any attempt at surgical amelioration of the condition was impossible.

This case belongs to the first type of cryptophthalmos (ablepharon by age­nesis) as all the palpebral structures were missing and there was no scar tissue to indicate an inflammatory origin.


  Summary Top


A case report of congenital bilateral cryptophthalmos with associated cleft palate is reported with clinical and histological studies.


  Acknowledgement Top


Our thanks are due to Dr. P. N. Dubey, Professor of Anatomy and Dr. R. V. Junnarkar, Professor of Pathology, Medical College, Nagpur for the photomicrographs and the histopathological report, respectively.[5]

 
  References Top

1.
Calan, J. S. (1964): Recent Advances in Surgery: 6th Edn. Lon., J. & A. Churchill.  Back to cited text no. 1
    
2.
Duke-Elder (1964): System of Ophthal­mology. Vol. 3 Pt. II. Lond., Henry Kimpton, p. 829.  Back to cited text no. 2
    
3.
Gupta and Saxena (1962): Brit. J. Ophthal. 46: 629.  Back to cited text no. 3
    
4.
Mann, Ida. (1957): Developmental Ab­normalities of the Eye. Lond.. Brit. Med. Assn., p. 372.  Back to cited text no. 4
    
5.
Pahwa. J. M. (1960): Proceedings of the All India Ophthalmological Society Vol. XIX. p. 64.  Back to cited text no. 5
    


    Figures

  [Figure - 1], [Figure - 2]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
Case Report
Obstetrical and ...
Discussion
Summary
Acknowledgement
References
Article Figures

 Article Access Statistics
    Viewed1041    
    Printed27    
    Emailed2    
    PDF Downloaded0    
    Comments [Add]    

Recommend this journal