The tight retracted lower eyelid.
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The shape of the eye prostheses depends on the plastic surgery type. Standard prostheses with thin but not sharp edges are used to recreate the conjunctival cavity, prostheses with a deep retraction or flat ones are employed for a delayed introduction into the stump, prostheses with a 'swelling' at the upper edge are of use in surgery to correct the upper eyelid falling in, prostheses with a flattened lower edge and a 'shelf' at the upper edge are used to fortify the lower eyelid. Individual prostheses are recommended after plastic surgery. The prostheses should not prevent free closing and blinking of the eyelids, retaining the identical opening of the eyes. An inadequately chosen prosthesis brings to nothing the tremendous work made by the surgeon. Ocular prosthetics may be regarded as the final stage stabilizing the results of plastic surgery.
Orbital ectoprosthesis is a method for rehabilitation of anophthalmia patients with severe extensive injuries in the orbital area. Analysis of 1230 case histories has helped define the indications and contraindications to this type of care. Good cosmetic results have been achieved in all the patients.
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Retinal projections, particularly the ipsilateral projections, to the medial terminal nucleus (MTN) of the accessory optic system were investigated by autoradiography in adult rats after being reared in one of three different conditions: (1) normal visual experiences, (2) an application of trypan blue for intrauterine induction of congenital unilateral anophthalmia; and (3) the procedures for intrauterine production of congenital microphthalmia in which both eyes are reduced in size. In congenital monocular rats, there was an increase of uncrossed retinal projections to the MTN which does not normally exist. The expansion of the ipsilateral projection was markedly greater in the monocular rats than those inflicted with microphthalmia. The expansion may be due to the failure of the retraction of the ipsilateral retinal projections to the MTN and the collateral sprouting of optic fibers from the remaining eye.
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Expansion of ipsilateral retinal inputs into terminal regions of the primary was assessed in rats enucleated at birth or as adults. In addition, one animal with a congenital absence of one eye received an injection of the label into the remaining eye and was similarly processed. Analysis of the sections revealed an increase in retinal inputs, relative to control injections, in the lateral geniculate nucleus and the superior colliculus. The increase observed in the brains of animals receiving enucleation at birth was greater than the increase observed after eye removal in the adult, although the greatest increase was observed in the animal with the congenital loss of one eye. Differences in the sprouting response within the various terminal areas as well as the age related decrease in the ability of retinofugal axons to sprout into denervated visual areas in the brain are discussed.
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A 72-year-old woman with chronic lymphocytic leukemia developed periorbital swelling, erythema, and discharge involving her anophthalmic left socket in the course of pseudomonas aeruginosa septicemia. Histopathologic examination of debrided eyelid tissues revealed ischemic necrosis of the eyelid margin and deeper eyelid tissues. Underlying malignancy, disseminated systemic infection, and alteration in the vascular supply to the eyelids following enucleation may have contributed to the development of ischemic eyelid necrosis in this patient.
Small eyes (Sey) is a semidominant, homozygous lethal mutation in the mouse (Roberts, 1967). It is allelic with SeyH, a radiation-induced homozygous prenatal lethal which has been mapped on chromosome 2. The effect of the Sey mutation is apparently limited to the growth and differentiation of the presumptive lens and nasal placodes. Homozygous Sey/Sey embryos can be distinguished as early as 10.5 days post coitum (p.c.); the optic vesicles grow out, but the ectoderm does not give rise to a lens and nasal pits never form. Immunohistochemical studies show that the distribution of the extracellular matrix glycoprotein laminin is not significantly different in the cephalic region of Sey/Sey versus Sey/+ or +/+ embryos. Sey/Sey embryos develop to term but without eyes or nose, and die soon after birth. Further analysis of Sey/Sey embryos may throw light on the mechanisms underlying morphogenesis of craniofacial structures in mammals.
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An autopsy case of sphenoethmoidal encephalomeningocele associated with anophthalmia, agenesis of the corpus callosum, cleft palate and nasal septum defect is presented. A small colloid cyst and a cyst of unknown nature were found in the third ventricle. Based on a review of the literature, a peculiar association of sphenoethmoidal encephalomeningocele with callosal defect and midline facial anomalies seems not to be fortuitous and we proposed to call it "Sakoda complex" as a distinctive disease entity. Pathogenetic mechanism and significance of separation of this syndrome are discussed from a embryological standpoint. Anophthalmia and the cyst of unknown nature are interpreted as midline anomalies that may be attributed to the same pathogenetic cause.
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