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    Acrylic conformers effective in congenital anophthalmia

    Treatment requires close collaboration among patient, ophthalmologist, ocularist


    One of the biggest challenges in the procedure is expanding the eyelids, Dr. Johnson said.

    “One needs to expand the eyelids to hold the ocular prosthesis, and you also need to expand the boney orbit, because if you don’t, the patient will end up with a constricted socket with the inability to wear a prosthesis,” he said.

    This approach works best with motivated parents because both the physician and the ocularist must see the patient frequently, he said.

    “If they lose their conformer they have to come in fairly quickly,” he said. “You need to have very dedicated parents.”

    Related: Single-layered closure successful in lower eyelid reconstruction

    Bilateral cases are easier to treat than unilateral ones because it can be difficult to exactly match the size of a natural eye with a prosthesis.

    “Symmetry is very important in facial appearance,” he added.

    The treatment requires a team approach. A geneticist and pediatrician should see the patient at the outset to determine whether other systemic abnormalities may result in comorbidities that must be managed.

    “Then it’s a very close collaboration between the ophthalmologist and the ocularist,” said Dr. Johnson. “You have to work with an excellent ocularist who is very patient with children.”

    Bataineh can fit the conformers without sedation or anesthesia.

    “Some people are very talented with that,” Dr. Johnson said. “It takes a special kind of person to be able to do it.”


    Thomas E. Johnson, MD

    E: [email protected]

    This article was adapted from Dr. Johnson’s delivery of the Ruedemann Lecture at the 2015 meeting of the American Academy of Ophthalmology. Dr. Johnson has no financial disclosures.


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