Artificial eye and facial prosthetic clinic

Congenital Abnormalities

Congenital Microphthalmia

A birth abnormality where the eye did not complete its development thus resulting in an abnormally small eye.

Congenital Anophthalmia

A birth abnormality where there is complete absence of the eyeball.

Congenital microphthalmos or congenital anophthalmos can be unilateral (one eye) or bilateral (both eyes). The child is referred to the ocularist by a pediatric ophthalmologist.

Depending upon the severity of the birth abnormality, it is often necessary to expand the eye socket(s) by the use of custom conformers to enable the artificial eye to be fitted. If this is required, the child is usually placed under a general anesthetic at Children's Hospital for an impression to be made of the eye socket. The general anesthetic is usually only required for the initial conformer. The custom acrylic conformer is based upon the shape obtained from the impression and is fitted in the ocularist's office with the child awake.

Several weeks later a larger conformer replaces the previous one. This helps to initiate the expansion process of the eye socket and is continued until the eye socket is of sufficient size to accommodate a full eye prosthesis. It is preferred to see the child as young as possible to start the expansion process! Two months of age is fairly common. The time taken to expand the eye socket for the provision of the prosthesis is very much an individual matter; however, it may be as short as two months or as long as one year or more depending how the socket responds to the expansion conformers. 

Microphthalmos and anophthalmos are rare congenital abnormalities. It is important for the family to be connected to a network of information and support during this time. Resources on this subject are limited; however, a parental support group is available at MAPS (Microphthalmia Anophthalmia Parent Support) at www.maparentsupport.com. Some information regarding this condition is also accessible through www.anophthalima.org or by calling 1-800-580-ICAN.

Our Journey with Microphthalmia

Our daughter was diagnosed with severe right eye microphthalmia at birth. She could hardly open her right eye at all. It was a surprise to our family and we were nervous about what to expect for her going forward.

After visits with Ophthalmology at BC Children’s Hospital, it was determined that there was no light perception, no viable optic nerve and no sight. We were referred to Marie Allen to begin the conformer process. We were advised that this was recommended to promote normal facial growth.

Marie, Heather and Liz were wonderful to meet. They were sensitive, informative and clear about the process ahead of us.

Our daughter had her first conformer at four weeks old, which was sized up and replaced every four to six weeks. This can be challenging but Marie, Heather and Liz were very patient and knew exactly what they were doing. She had six conformers total before receiving her painted shell at 8.5 months old. Her shell is beautiful and matches her other eye perfectly. You would never guess!

I am amazed by what the team here has been able to do. When meeting people, I have full confidence that her micro eye is not something they notice - they just see her smile!

While we are sure to take care for her eyes, shell and her vision, her microphthalmia has become of decreasing concern to our family - we’re just having fun with her and keeping her out of trouble like any other kid.

We can’t thank Marie, Heather and Liz for what they’ve done. We’re so happy to be working with them for the years to come.