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