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Submitted: 28 June 2018 Modified: 05 July 2018
HERDIN Record #: R07-VSMMC-18062815581110

Congenital bilateral upper eyelid coloboma with corneopalpebral adhesions and exposure keratopathy secondary to poor bell's phenomenon.

Juan Carlos  B. Marzan

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Congenital eyelid coloboma is part of a spectrum of various eye defect with a  deduced approximation of incidence that is between 1:12000 to 1:57000 live births.The exact disease burden of uncorrected eyelid coloboma remains to be unreported but worldwide, it is animportant cause of vision loss in children. We report a documented case of an 8 month old baby girl with congenital upper eyelid coloboma with corneopalpebral adhesions and exposure keratopathy secondary to poor bell's phenomenon. The coloboma defect size is more than half of the total length of the upper eyelid. Upon initial consult, patient is borderline malnourished with a Z score of -2. Surgery was delayed until nutritional status was improved (above Z score -2) . During the interim, ample lubrication of the exposed cornea was ensured using eyedrops / eye lubricants. Eyelid colobomas may be classified as small, moderate and large. In this case, the defect is classified as a large size upper eyelid coloboma, a lid sharing technique is  therefore recommended. Lid-sharing procedures are of two types - advancement flap (Cutler-Beard) and switch flap (Abbe-like Flap), we opted to do an Abbe-like flap procedure, which is a staged procedure, with 3 weeks flap division and insetting interval to minimize the risk of occlusion amblyopia. Postoperatively, patient was well and stable, with acceptable results. Hopefully, the reporting of this case will bring increased awareness of this condition and that reconstructive measures can be achieved in our institution.

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Research Report
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