PROSTHETIC TREATMENT OF CONGENITAL ANOPHTHALMIA

Congenital anophthalmia must be said to be a fairly rare malformation. However, it is by no means an ophthalmological rarity, and in the course of time it has, together with other ocular malformations, been the subject of considerable scientific interest. The literature on congenital anophthalmia is by now quite considerable. It has dealt with the embryological, clinical, genetic, and histological aspects of this subject. In addition, there have been experimental studies which have greatly contributed to the understanding of the aetiology and genesis of this malformation. On the other hand, its therapeutic aspects have not, on the whole, previously received much attention in the literature. The definition of this condition has been discussed, and various principles of classifying the various manifestations of anophthalmia have been suggested by different authors. It has been emphasized that the term congenital anophthalmia can be used, in the strict sense of this word, only if the presence of the mesodermal as well as ectodermal tissues of the eye can be excluded. However, this can be established only by histological examination of serial sections of the orbital content. Since normally this is not available, it is usually impossible to distinguish in practice between true anophthalmia and cases which in fact ought to be assigned to extreme degrees of microphthalmia (Robinson, Loddoni & Duc and others). Between true anophthalmia and microphthalmia there are numerous transition stages (Bntke’s incomplete anophthalmia) . Therefore, the term clinical anophthalmia (Duke-Elder) is used for all cases in which the eyeball is apparently absent, including those which presumably ought to be called microphthalmia. In many cases it would be possible to observe a small rudiment of the eyeball, often the size of a pea, at the bottom of a small conical cavity. Histologically, such rudiments are seen to consist of mesodermal (scleral and choroidal) tissue (incomplete anophthalmia), but none of the neuro-ectodermal elements of the eye. In other