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