Saturday, Apr 1, 2023 by Nisha Gupta, MD

This month we will talk about colobomas.

What is a coloboma?

A coloboma is an eye abnormality where a specific part of the eye is missing at birth. The eye usually develops in the first few months of a fetus’ growth. A disruption in this process leads to part of the normal tissue not forming properly. It can affect one or both eyes. These can be genetic or part of another syndrome affecting other parts of the body.

What parts of the eye are affected?

Colobomas can affect the eyelid, lens, macula, optic nerve, iris, and retina.

What are the symptoms?

Symptoms depend on the size and location of the coloboma. An eyelid coloboma would have a notch or missing area in the eyelid. Iris colobomas are more visible because they make the pupil appear larger and oval. These may cause blurry vision and increased sensitivity to light.

Macula and optic nerve colobomas will cause blurry vision. Retina colobomas may cause a decrease in peripheral vision. They can also lead to retinal detachment.

How is it detected?

A comprehensive exam including checking the vision and dilating the eyes is imperative. Eye exams may be done to examine the inside of a baby’s eye. As a child gets older, proper vision tests can be done.

What are the treatments?

There is no cure for a coloboma and treatments depend on what part of the eye is affected.

Glasses or contact lenses: These can help improve the vision. Colored contact lenses may help with the appearance of iris colobomas.

Low vision devices: These resources are useful when glasses and contact lenses are unable to improve the vision.

Surgery: Surgery can improve the appearance of an iris coloboma. It may be necessary to fix an eyelid or lens coloboma.

Eye patch or drops: Children with colobomas in one eye are at risk for developing amblyopia (lazy eye). A patch or drops are used in the unaffected eye to strengthen the eye with the coloboma.

It is imperative to have regular assessments from an ophthalmologist to gauge changes in vision and manage potential problems that may arise from colobomas, such as cataracts.

Return next month for a discussion on a new topic!

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