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CONGENITAL ABNORMALITIES OF THE EYE- ANOPHTHALMOS (Risk Factors (Trisomy…
CONGENITAL ABNORMALITIES OF THE EYE- ANOPHTHALMOS
Definition
This is the absence of the of one or two eye balls,it may be a result of failure in the formation of the optic vesicle
Causes
Primary Anopththalmos
is a complete absence of eye tissue due to a failure of the part of the brain that forms the eye.
Secondary Anophthalmos
the eye starts to develop and for some reason stops, leaving the infant with only residual eye tissue or extremely small eyes which can only be seen under close examination.
Degenerative Anophthalmos
the eye started to form and, for some reason, degenerated. One reason for this occurring could be a lack of blood supply to the eye.
Diagnostic Studies
Pre-Natal
Ultrasound
Amniocentesis
Post Natal
MRI and CT Scan
Physical Examination
Risk Factors
Trisomy 13
Lenz Syndrome
Goldenhar-Gorlin Syndrome
Waardenburg syndrome
Surgical Management
Prosthetic eye
the child will need to go to a prosthetic specialist to have conformers fitted into the eye. Conformers are made of clear plastic and are fitted into the socket to promote socket growth and expansion. As the child's face grows and develops, the conformer will need to be changed. An expander may also be needed in anophthalmia to expand the socket that is present
Cosmetic surgery
If the proper actions are not taken to expand the orbit, many physical deformities can appear. It is important that if these deformities do appear, that surgery is not done until at least the first two years of life. Many people get eye surgery, such as upper eyelid ptosis surgery and lower eyelid tightening. These surgeries can restore the function of the surrounding structures like the eyelid in order to create the best appearance possible. This is more common with people who have degenerative anophthalmia
Nursing Care Plan
Poor or No Vision
Nursing Diagnosis
Poor or loss of vision due to disease process or congenital disorders
Expected Outcome
Nutritional status restored
Gain in independence in cases of impaired vision
Nursing Interventions
Do eye swabbing and administer medication as prescribed
Shield the eyes from the light accordingly and rest the eyes as required
Support the patient when there is permanent loss of sight
Refer patient to blind society for enrollment into their programmes
Give a balnced diet rich in vitamins A and C and proteins.
Evaluation
Patients is eating vegetables in the form of salads and fruits and vegetables
Anxiety(Related to Physical Limitations)
Nursing Diagnosis
Anxiety related to physical limitations on performance activities
Expected Outcomes
Patient able to move around freely to do their chores
Nursing Interventions and Rationale
Provide information on capabilities of the visually impaired and provide support
Evaluation
Patient talks freely about their situation and is able to communicate what they can and cannot do
Pathophysilogy
Anophthalmia occurs when the neuroectoderm of the primary optic vesicle fails to develop properly from the anterior neural plate of the neural tube during embryological development. The more commonly seen microphthalmia can result from a problem in development of the globe at any stage of growth of the optic vesicle.
Medical Mangement
A solid conformer may be placed in the orbit to stimulate bony orbital growth and to enlarge the orbital cavity in an attempt to attain normal proportions.
Signs and Symptoms
Orbital
Small orbital rim and entrance
Reduced size of the bony orbital cavity
Extraocular muscles are usually absent.
Lacrimal gland and ducts may be absent.
Small and maldeveloped optic foramen
Eyelid
Foreshortening of the lids in all directions
Absent or decreased levator function with decreased lid folds
Contraction of orbicularis oculi muscle
Shallow conjunctival fornix, especially inferiorly
Globe
Globe is completely absent in primary anophthalmos.
Extremely small and malformed globe is seen in microphthalmos.
Congenital cataract associated with microphthalmos
