Lid Coloboma

Lid Coloboma
SYMPTOMS Typically asymptomatic but could experience dry eyes
SIGNS Small marginal notch to full-thickness defect in the lid, Exposure keratopathy and/or dry eyes if there is corneal exposure
WORK-UP Pupils, EOMs, Full eye exam, NaFl staining
TREATMENT Monitor lid coloboma
Artificial tears, Lubricating ointment, Moisture chamber, and/or Scleral lenses for treatment of dry eyes and/or exposure keratopathy
Refer to an oculoplastic specialist or pediatric ophthalmologist for potential eyelid reconstruction
FOLLOW-UP See patient back in 12 months in order to monitor lid coloboma
See patient back in 3-6 months if patient presents with exposure keratopathy and/or dry eyes secondary to corneal exposure
Once the lid coloboma is treated by an oculoplastic specialist/pediatric ophthalmologist and the eye is stable, the patient should be seen back in 6-12 months
ADDITIONAL LAB | TESTS Refer to PCP in order to rule out any potential syndromes associated with lid colobomas: Fraser syndrome, Goldenhar syndrome, Treacher Collins syndrome, CHARGE syndrome, Oculocerebrocutaneous syndrome, MOTA syndrome
ETIOLOGY Congenital (form of a facial cleft)
DIFFERENTIAL DX Cicatricial eyelid, Eyelid laceration
NOTES Can involve both the upper and lower lid (upper lid more common)
Can be unilateral or bilateral
Coloboma can also involve the iris, lens, retina, and/or optic nerve
High refractive error and strabismus are associated with lid colobomas

Leave a Comment

You must be logged in to post a comment.