Microphthalmus

My baby has microphthalmus and the ophthalmologist said that she will get a prosthetic shell when she reaches school age (around 3 or 4 years). How possible will it be considering that there has been no use of conformers to ensure that her skull develops properly? She has a small globe in her left eye, can it stimulate normal growth of the orbital space or is more needed? So far she looks normal in terms of face symmetry but she is only 6 months old. Your help will be appreciated.

[Houman Vosoghi, MD]

You need to consult with a competent Oculoplastic surgeon who has experience dealing with this kind of thing in children.  Sometimes, the eye is removed and sequentially larger implants (or a the largest implant that would fit) are placed to ensure the socket of the eye doesn't shrink around a smaller eyeball.  Of course, this all depends on how bad the eye is currently and you need to wait for the full exam to get the best course of action.  Your thoughts about at least placing conformers makes sense to me if the eye is significantly smaller on that side so it is important you find such a specialist.  Your best bet would be to find where the nearest hospital is that children with retinoblastoma or eye cancer get treated as it is likely the work closely with such a specialist.  There are children's hospitals with such capabilities in multiple large cities in the country as well as St. Judes in Memphis (central location).  If you tell me what part of the country you are in I'll check and see if I have any contacts near you that may be able to help us locate one.  Good luck.

HV