Friday, October 25, 2013

The Baby Born with Missing Upper Eyelids (Coloboma)

While most of the cases I did in private practice are aesthetic cases, I do occaionally get  referred unusual cases such as tumour and congenital defects. Unfortunately, most of these functional cases appear to affiliate poorer people who could least afford private health care. On the bright side, Malaysia still has good health care system where these people could still get treatment in governement hospital either free or pay only nominal cost.
This baby was born with failure of the upper eyelids to fuse. This is medically termed coloboma and if left untreated can lead to scarring and blindness. The parents were poor so the baby was referred to the General Hospital for closure of the lids. The good things about working in General Hosptial is that one can see challenging conditions for honing one's surgical skills. Of course, the ability to help the less fortunate in the society is an added bonus.

a. Coloboma of the upper eyelids. b. Tenzel's flap used to close the defect.
c. Cutting the edge of the coloboma and remove the symblepharon.
d. Lifting the flap. e. Closing the defect. f. End of the operation.

g. Appearance at one week. h. Appearance at 4 weeks.

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